 |
|
Study examines factors associated with survival in advanced laryngeal cancer
December 18, 2007Type of treatment, sex, race and insurance status are associated with survival rates among patients with advanced laryngeal cancer, according to a report in the December issue of Archives of Otolaryngology-Head & Neck Surgery, one of the JAMA/Archives journals.
About 10,000 U.S. men and women each year are diagnosed with cancer of the larynx, or voice box, according to background information in the article. For many years, total removal of the larynx (laryngectomy) followed by radiation therapy was the standard treatment. "Unfortunately, patients treated with total laryngectomy experience a complete loss of voice and may also experience impairment of swallowing function, leading to decreased quality of life in many aspects, including nutrition, social functioning and personal hygiene." Following additional clinical trials, some patients began receiving chemotherapy followed by radiation therapy as a larynx-preserving treatment.
Amy Y. Chen, M.D., M.P.H., of Emory University and the American Cancer Society, Atlanta, and Michael Halpern, M.D., Ph.D., also of the American Cancer Society, analyzed data from a national cancer registry containing 7,019 patients diagnosed with advanced laryngeal cancer between 1995 and 1998. Of these, 53.6 percent underwent total laryngectomy, 30.6 percent radiation therapy (radiotherapy) alone and 15.8 percent combined chemotherapy and radiotherapy.
"Controlling for the other included factors, the radiotherapy and chemo-radiotherapy groups had lower odds of survival than did the total laryngectomy group," the authors write. "The increased risk associated with death is approximately 30 percent for the chemo-radiotherapy group and 60 percent for the radiotherapy group."
In addition, men were less likely to survive than women, those with stage IV disease were less likely to survive than those at stage III, black patients were more likely to die than white patients and uninsured patients and those with Medicaid, Medicare or other government health plan coverage were more likely to die than those with private insurance. "We do not believe that insurance status in this analysis represents differential treatment or quality of care for patients with advanced laryngeal cancer," the authors write. "Rather, insurance status is likely a proxy for multiple medical care issues, including usual source of medical care, participation in screening and preventive care activities and exposure to related risk factors, including alcohol and/or tobacco use and poor diet, all of which can influence overall survival."
"In conclusion, this analysis demonstrates that total laryngectomy yields the highest likelihood of survival for patients with advanced laryngeal cancer," the authors write. "These results differ from those of previous analyses comparing total laryngectomy and chemo-radiotherapy, suggesting that caution is needed when applying clinical trial findings to broader medical care settings and populations."
JAMA and Archives Journals
"Controlling for the other included factors, the radiotherapy and chemo-radiotherapy groups had lower odds of survival than did the total laryngectomy group," the authors write. "The increased risk associated with death is approximately 30 percent for the chemo-radiotherapy group and 60 percent for the radiotherapy group."
In addition, men were less likely to survive than women, those with stage IV disease were less likely to survive than those at stage III, black patients were more likely to die than white patients and uninsured patients and those with Medicaid, Medicare or other government health plan coverage were more likely to die than those with private insurance. "We do not believe that insurance status in this analysis represents differential treatment or quality of care for patients with advanced laryngeal cancer," the authors write. "Rather, insurance status is likely a proxy for multiple medical care issues, including usual source of medical care, participation in screening and preventive care activities and exposure to related risk factors, including alcohol and/or tobacco use and poor diet, all of which can influence overall survival."
"In conclusion, this analysis demonstrates that total laryngectomy yields the highest likelihood of survival for patients with advanced laryngeal cancer," the authors write. "These results differ from those of previous analyses comparing total laryngectomy and chemo-radiotherapy, suggesting that caution is needed when applying clinical trial findings to broader medical care settings and populations."
JAMA and Archives Journals
Cost-benefit analysis: Combo treatment costs more, saves money later
From a health insurer's perspective, the most effective cancer treatment may also be the most cost-effective.
Treatment method improves survival for advanced laryngeal cancer, U-M study finds
Chemotherapy and radiation can be effective at treating cancer of the larynx, or voice box, without removing the organ that controls speech and swallowing. But it doesn't work for everyone.
K.U.Leuven Scientist Develops New Surgical Technique For Laryngeal Tumours
Professor Pierre Delaere (Otorhinolaryngology section, K.U.Leuven) has in the past decade developed a new surgical technique for larynx reconstruction. In an increasing number of cases, this innovative technique can save the larynx in patients suffering from vocal cord cancer. Patients are able to breathe, swallow and speak normally following the operation, something that was previously impossible since the entire larynx frequently needed to be removed, even if only one vocal cord was affected. The larynx separates the digestive system and the respiratory system. If the larynx is removed then the separation must be effected in some other way. Persons without a larynx can still eat if the oes
Accelerated Radiotherapy More Effective For Treating Head And Neck Cancer (p 933)
Danish research published in this week's issue of THE LANCET provides strong evidence that the shortening of radiotherapy treatment time has definitive benefits for people being treated for head and neck cancer. There is debate among oncologists about the optimum treatment time for patients given radiotherapy for head and neck cancer. Jens Overgaard from Aarhus University Hospital, Denmark, and colleagues investigated whether the shortening of treatment time by use of six instead of five radiotherapy fractions per week improved patients' tumour response. In a randomised controlled trial between 1992 and 1997, around 1400 patients with head and neck cancer were allocated to receive either fi
Faster radiotherapy more effective in head and neck cancer, trial shows
The world's largest trial in accelerated radiotherapy for head and neck cancer - the DAHANCA trial - proves conclusively that increasing the number of treatments per week from five to six can benefit patients.
More Laryngeal Cancer News Articles
 | Practical Guide to Neck Dissection by Marco Lucioni This brilliantly illustrated manual is a road map for the surgeon who wishes to perform a dissection exercise on the neck in the anatomic theatre. It guides the reader step by step through the cervical structures, the aim being to improve his/her technical skills in surgical practice in the operating room. This book is divided into sections, beginning with the most superficial structures, and... |
| Organ Preservation Surgery For Laryngeal Cancer by Gregory S. Weinstein, Ollivier Laccourreye, Daniel Brasnu, Henri Laccourreye Organ Preservation Surgery for Laryngeal Cancer is the first book/CD-ROM package to focus solely on the surgical techniques that preserve the functions of speech and swallowing without a permanent tracheostomy. Written by leading international authorities, this new groundbreaking work... | |
| Laryngeal Cancer, An Issue of Otolaryngologic Clinics (The Clinics: Surgery) by Nasir I. Bhatti, Ralph Tufano The August 2008 issue of Otolaryngologic Clinics addresses dynamic aspects of laryngeal cancer management and provides an overview of the complex considerations one must appreciate when managing laryngeal cancer to maximize oncologic and functional outcomes for patients. Topics include: Molecular genetics, Diagnosis and preoperative workup, Radiologic evaluation of larynx cancer,... | |
| Cancer of the Larynx (Clinical Cancer Monographs) by P.E. Powell, Peter E. Robin, Guy M. Holme, John A.H. Waterhouse, Christopher C. McConkey, Janet E. Robertson | |
| Diagnosis and treatment of cancer of the glottis and subglottis (Continuing education program) by Joseph L Leach | |
| Malignant disease of the larynx (carcinoma and sarcoma) by Philip Robert William De Santi | |
| Cancer of the larynx,: By Chevalier Jackson and Chevalier L. Jackson by Chevalier Jackson | |
 | 21st Century Complete Medical Guide to Head and Neck Cancer (Lip, Oral Cavity, Salivary Gland, Laryngeal, Pharyngeal, Nasal and Sinus Cancer) - Authoritative ... on Diagnosis and Treatment Options by PM Medical Health News This up-to-date and comprehensive CD-ROM provides a superb collection of official Federal government documents on head and neck cancers: signs and symptoms, diagnosis, lab tests, treatment and management options, and ongoing clinical research. Every aspect of the disease is thoroughly covered. There is no other reference that is as fast, convenient, and portable - everything you need to know,... |
| Growth and spread of laryngeal and hypopharngeal carcinoma with reflections on the effect of preoperative irradiation, (Acta oto-laryngologica. Supplementum) by Jan Olofsson | |
| Gale Encyclopedia of Medicine: Laryngectomy by Tish D. Davidson A.M. The article is excerpted from Gale Encyclopedia of Medicine. Consult the second edition of this authoritative, comprehensive, in-depth medical guide for information on more than 1,700 medical topics in language accessible to adult laypersons. Presented in a single alphabetical sequence, articles range in length from one or two paragraphs for minor topics, to several pages or more for major... |
| © 2008 BrightSurf.com |