Salvage surgery following radiation failure for laryngeal cancer in elderly patients

Otolaryngol Head Neck Surg. 2011 Nov;145(5):759-66. doi: 10.1177/0194599811414396. Epub 2011 Jul 12.

Abstract

Objective: To find the survival rate of patients ≥ 80 years old who undergo salvage surgery for squamous cell carcinoma of the larynx.

Study design: National data registry analysis.

Setting: Seventeen population-based registries comprising the National Cancer Institute's Surveillance, Epidemiology, and End Results database.

Subjects and methods: Overall, cancer-specific, and relative survival rates were calculated from 1418 patients, stratified into 3 age cohorts, who underwent surgery following radiation therapy for treatment of laryngeal cancer.

Results: The 1-year overall survival of patients ≥ 80 years old (n = 57) was 76.1%. The cancer-specific survival at 1 year was 86.4%. These survival rates were significantly less than those of patients <65 years old (n = 869), who had a 1-year overall survival of 88.1% (P = .006) and cancer-specific survival of 90.5% (P = .029). Patients aged between 65 and 79 years old (n = 492) displayed 1-year overall survival of 80.7% (P = .426) and cancer-specific survival of 85.1% (P = .711), which were not significantly different from the ≥ 80 year cohort. When comparing relative survival at 5 years, the ≥ 80-year-old cohort's survival trended the highest (≥ 80 years, 62.8%; 65-79 years, 51.3%; 20-64 years, 56.2%).

Conclusion: While patients ≥ 80 years old have a less favorable prognosis than patients <65 years old, the survival rates of patients ≥ 80 years old are not significantly different from the 65- to 79-year-old cohort. After controlling for non-cancer-related death, patients ≥ 80 years old appear to have similar 5-year survival outcomes compared with other patients.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / radiotherapy
  • Carcinoma, Squamous Cell / surgery*
  • Female
  • Humans
  • Laryngeal Neoplasms / radiotherapy
  • Laryngeal Neoplasms / surgery*
  • Male
  • Salvage Therapy / methods*
  • Treatment Failure