Prognostic factors for survival and nonfunctional larynx in patients with squamous cell carcinoma of the larynx

OBJECTIVES/HYPOTHESIS: Prognostic variables upon presentation can assist in recommending the optimal treatment for patients and may help in management of patient's expectations and side effects. Our objective was to evaluate prognostic factors for survival and nonfunctional larynx in patients with laryngeal squamous cell carcinoma (SCC). STUDY DESIGN: Retrospective chart review. METHODS: All patients diagnosed as having laryngeal SCC from January 2007 through December 2016 in a tertiary, university-affiliated medical center were reviewed. Main outcomes were survival and nonfunctional larynx rate. RESULTS: Two hundred sixty-five patients were identified; the male:female ratio was 4.5:1. Mean age at diagnosis was 64 +/- 11.8 years. Overall and disease-free survival were 7.9 and 6.7 years, respectively. A univariate analysis found that older age significantly affected survival. Alcohol abuse, diabetes mellitus, and advanced disease stage at presentation were also found to decrease survival but were not significant. A multivariate Cox regression found age, alcohol abuse, and advanced disease stage to significantly affect and lower survival (P < .05). Of the entire cohort 19% were defined as having a nonfunctional larynx (e.g., tracheostomy or feeding-tube dependent). A backward logistic regression found that male sex and advanced disease stage increased the risk, and anterior commissure involvement was found to lower the probability of nonfunctional larynx (P < .01). CONCLUSIONS: Older age, history of alcohol use, and advanced disease stage at presentation negatively affect survival in larynx cancer patients. Male gender and advanced disease stage increased the risk, and anterior commissure involvement was found to lower the risk for tracheostomy or feeding-tube dependency. LEVEL OF EVIDENCE: 4 Laryngoscope, 130:1202-1205, 2020.