Survival outcomes of patients with subglottic squamous cell carcinoma : a study of the National Cancer Database

Eur Arch Otorhinolaryngol. 2021 Dec;278(12):4923-4932. doi: 10.1007/s00405-021-06712-w. Epub 2021 Mar 1.

Abstract

Background: Subglottic squamous cell carcinoma (SCC) represents less than 5% of all laryngeal cancers. Our objective was to better characterize survival using the National Cancer Database (NCDB) registry from 2004 to 2015.

Results: 403 patients met inclusion criteria. 63.8% presented with advanced-stage disease. Treatment regimens were as follows: 15.9% underwent surgery alone, 16.9% underwent surgery followed by adjuvant therapy, and 67.2% underwent primary chemo/radiation (C/RT). Five-year overall survival (OS) was 58.6% for Stage I and II patients, 49.1% for Stage III, and 36.3% for stage IV. Adjusted OS for all-stage patients was worse with C/RT compared to upfront surgery (40.6% vs. 58.4%; HR 1.83 [95%CI 1.29-2.61] p < 0.001) and adjusted OS for stage 4 disease was significantly worse with C/RT compared to surgery (26.0% vs. 45.2%, HR 1.79 [95%CI 1.17-2.73] p = 0.007).

Conclusion: Majority of patients were treated with primary C/RT. Adjusted survival favors upfront surgery versus C/RT, especially in patients with Stage IV disease.

Keywords: Head and neck cancer; Laryngeal squamous cell carcinoma; NCDB; Subglottis; Survival outcomes.

MeSH terms

  • Carcinoma, Squamous Cell* / pathology
  • Carcinoma, Squamous Cell* / therapy
  • Combined Modality Therapy
  • Head and Neck Neoplasms*
  • Humans
  • Laryngeal Neoplasms* / pathology
  • Laryngeal Neoplasms* / therapy
  • Neoplasm Staging
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck / therapy
  • Survival Rate