Impact of surveillance on survival after laryngeal cancer in the medicare population

Laryngoscope. 2009 Dec;119(12):2337-44. doi: 10.1002/lary.20576.

Abstract

Objectives/hypothesis: 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.

Study design: Retrospective cohort study.

Methods: 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.

Results: 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).

Conclusions: 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.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Combined Modality Therapy
  • Confidence Intervals
  • Female
  • Follow-Up Studies
  • Humans
  • Laryngeal Neoplasms / mortality*
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / therapy
  • Male
  • Medicare / statistics & numerical data*
  • Neoplasm Recurrence, Local / mortality*
  • Odds Ratio
  • Prognosis
  • Retrospective Studies
  • SEER Program*
  • Survival Rate / trends
  • United States / epidemiology