Trends in treatment and survival for advanced laryngeal cancer a 20-year population-based study in The Netherlands

BACKGROUND:
The purpose of this study was to determine time trends for primary treatment modalities in advanced laryngeal cancer, overall survival (OS), and laryngectomy-free interval (LFI) over the last 2 decades in The Netherlands.

METHODS:
We conducted an analysis of T3 to T4 laryngeal cancer data from 2 combined national (population-based and pathology-based) cancer registries.

RESULTS:
A total of 2072 T3 cases (14.7%) and 1722 T4 cases (12.2%) were identified. Total laryngectomy as primary treatment modality decreased, whereas radiotherapy (RT) increased. For T3 disease, 5-year OS after primary total laryngectomy (+/- adjuvant RT), RT, and chemoradiotherapy (CRT) was 49%, 47%, and 45%, respectively. For T4 disease, this was 48%, 34%, and 42% (overall p < .0001), respectively. Five-year LFI for T3 disease was 81% (RT) and 77% (CRT), and for T4 disease it was 81% and 87%, respectively.

CONCLUSION:
From 1991 to 2010 total laryngectomy as primary treatment modality for advanced laryngeal cancer decreased and RT increased. T3 disease showed similar survival rates for all primary treatment modalities. For T4 disease, total laryngectomy (+ adjuvant RT) showed the best survival.