Patterns of care and survival outcomes for laryngeal small cell cancer

Head Neck. 2019 Mar;41(3):722-729. doi: 10.1002/hed.25430. Epub 2018 Dec 10.

Abstract

Background: To determine practice patterns and outcomes of laryngeal small cell cancer (LSCC) across the United States.

Methods: Patients with LSCC were identified in the National Cancer Database. Overall survival (OS) was compared with Kaplan-Meier analysis and Cox regression.

Results: From 2004 to 2014, the 5-year OS for early stage (n = 47), locally advanced stage (n = 133), and metastatic disease (n = 53) was 34%, 26%, and 9%, respectively. Chemoradiation was given in 66% of cases. Chemotherapy was less likely given in early stage disease (P = .001), and definitive radiation was less likely given in metastatic disease (P < .001). Definitive radiation improved median OS in locally advanced LSCC (20 vs. 7 months, log-rank P = .04). In multivariable modeling, radiation dose ≥40 Gy was associated with better OS (P < .001).

Conclusion: Chemoradiation was the most common practice for treating locally advanced LSCC, and radiation dose ≥40 Gy was associated with improved OS.

Keywords: chemotherapy; head and neck; neuroendocrine cancer; radiation; surgery.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Small Cell / mortality*
  • Carcinoma, Small Cell / pathology
  • Carcinoma, Small Cell / therapy*
  • Chemoradiotherapy
  • Databases, Factual
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Laryngeal Neoplasms / mortality*
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / therapy*
  • Male
  • Middle Aged
  • Practice Patterns, Physicians'*
  • Proportional Hazards Models
  • Survival Rate
  • Treatment Outcome
  • United States
  • Young Adult