Presented at American Laryngological Association, Combined Otolaryngology Spring Meeting, Resident Research Award, Phoenix, Arizona, U.S.A., May 28–31, 2009.
Head and Neck
Impact of surveillance on survival after laryngeal cancer in the medicare population†
Article first published online: 28 AUG 2009
Copyright © 2009 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 119, Issue 12, pages 2337–2344, December 2009
How to Cite
Francis, D. O., Yueh, B., Weymuller, E. A. and Merati, A. L. (2009), Impact of surveillance on survival after laryngeal cancer in the medicare population. The Laryngoscope, 119: 2337–2344. doi: 10.1002/lary.20576
- Issue published online: 20 NOV 2009
- Article first published online: 28 AUG 2009
- Manuscript Accepted: 11 MAY 2009
- American Academy of Otolaryngology–Head & Neck Surgery Foundation
- Health Service Research CORE
- Laryngeal cancer;
Routine surveillance is advocated to detect recurrent disease after treatment for laryngeal cancer. This aim of this study was to determine the 1- and 5-year postrecurrence mortality for laryngeal cancers and evaluate whether more intensive surveillance improved survival.
Retrospective cohort study.
Patients with recurrent cancers (1992–1999) were identified in a national cancer clinical database. Multivariate analysis was used to evaluate the effect of surveillance on postrecurrence survival.
Of 2,121 recurrent cancers identified, 913 were laryngeal. Patients with laryngeal cancer recurrence had 27% (P = .001) and 22% (P = .007) better odds of 1- and 5-year survival than other sites. The 1- and 5-year postrecurrence survival rates for laryngeal cancer patients were 72.4% and 41.3%, respectively. Glottic cancer cases had the best postrecurrence life expectancy. Multivariate regression revealed that clinical surveillance intensity had no independent impact on their survival (P < .05). However, patients with recurrent glottic cancer seen in surveillance had 23% improved odds of survival (P = .037).
More frequent surveillance visits was not associated with a survival advantage in the overall population. Patients with glottic cancer had a postrecurrence survival advantage if seen during the surveillance period. Laryngeal cancer patients had better postrecurrence survival than other head and neck sites. Laryngoscope, 2009