Survival and laryngeal preservation tradeoff in advanced laryngeal cancer: From the otorhinolaryngology patient to the managing physician

Head Neck. 2017 Oct;39(10):1984-1989. doi: 10.1002/hed.24833. Epub 2017 Aug 8.

Abstract

Background: The purpose of this study was to document the tradeoff between survival and laryngeal preservation in advanced-stage laryngeal cancer amenable to chemoradiation or total laryngectomy.

Methods: We conducted a prospective analysis based on a questionnaire completed by 209 laryngeal cancer specialists and 269 volunteers from an otorhinolaryngology clinic.

Results: Of the responders, 34.5% would not consider any decrease in survival to preserve their larynx. This percentage varied from 52% in otorhinolaryngologists to 27.3% in radiotherapists and 28.6% in volunteers (P < .001). Among the responders prepared to trade, the percentage of survival they were willing to trade to preserve their larynx varied from 5% to 100% (median 30%). On univariate analysis, 3 variables significantly affected this percentage: (1) the living status (single or not); (2) the existence of children; and (3) the study group (volunteers, radiation therapists, or otorhinolaryngologists) to whom the responders belong.

Conclusion: The significant variations noted should develop modes of practice that cater to this and stimulate further research in this field.

Keywords: laryngeal cancer; organ preservation; tradeoff.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Attitude to Health*
  • Female
  • Humans
  • Laryngeal Neoplasms / mortality
  • Laryngeal Neoplasms / surgery*
  • Larynx / pathology
  • Male
  • Middle Aged
  • Organ Sparing Treatments / statistics & numerical data*
  • Patients
  • Physicians
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Prospective Studies
  • Surveys and Questionnaires
  • Survival Rate
  • Young Adult