The impact of operability status on outcomes in patients with T4 larynx cancer undergoing larynx preservation

Ashley J. Schlafstein; Subir Goyal; Arya Amini; Sana D. Karam; Nabil F. Saba; Azeem S. Kaka; Ashley H. Aiken; Jonathan J. Beitler; William A. Stokes

doi:10.1002/hed.27204

The impact of operability status on outcomes in patients with T4 larynx cancer undergoing larynx preservation

Ashley J. Schlafstein, Subir Goyal, Arya Amini, Sana D. Karam, Nabil F. Saba, Azeem S. Kaka, Ashley H. Aiken, Jonathan J. Beitler, William A. Stokes

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Large analyses of T4 larynx cancer (LC) have raised concerns that larynx preservation (LP) contributes to reduced survival compared with laryngectomy (LGX). The role of operability has not been previously considered as a confounder. Methods: We queried the National Cancer Database for T4M0 LC diagnosed 2004–2015. Patients were categorized as undergoing LGX, chemoradiotherapy but operable (LP-operable), and chemoradiotherapy inoperable (LP-inoperable). Overall survival (OS) was estimated by Kaplan–Meier. Cox multivariate analysis (MVA) identified variables associated with OS. Results: We identified 1405 LGX, 164 LP-operable and 1969 LP-inoperable patients. Compared with LGX, MVA demonstrated worse OS among LP-inoperable (HR 1.28 95%CI 1.17–1.40, p < 0.01) but not LP-operable patients (HR 1.12 95%CI 0.91–1.39, p = 0.28). Conclusions: LP-operable patients did not have significantly worse OS than those undergoing LGX.

Original language	English
Pages (from-to)	2854-2864
Number of pages	11
Journal	Head and Neck
Volume	44
Issue number	12
DOIs	https://doi.org/10.1002/hed.27204
State	Published - Dec 2022

Keywords

laryngeal neoplasms
laryngectomy
organ preservation
radiation
radiotherapy

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10.1002/hed.27204

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title = "The impact of operability status on outcomes in patients with T4 larynx cancer undergoing larynx preservation",

abstract = "Background: Large analyses of T4 larynx cancer (LC) have raised concerns that larynx preservation (LP) contributes to reduced survival compared with laryngectomy (LGX). The role of operability has not been previously considered as a confounder. Methods: We queried the National Cancer Database for T4M0 LC diagnosed 2004–2015. Patients were categorized as undergoing LGX, chemoradiotherapy but operable (LP-operable), and chemoradiotherapy inoperable (LP-inoperable). Overall survival (OS) was estimated by Kaplan–Meier. Cox multivariate analysis (MVA) identified variables associated with OS. Results: We identified 1405 LGX, 164 LP-operable and 1969 LP-inoperable patients. Compared with LGX, MVA demonstrated worse OS among LP-inoperable (HR 1.28 95%CI 1.17–1.40, p < 0.01) but not LP-operable patients (HR 1.12 95%CI 0.91–1.39, p = 0.28). Conclusions: LP-operable patients did not have significantly worse OS than those undergoing LGX.",

keywords = "laryngeal neoplasms, laryngectomy, organ preservation, radiation, radiotherapy",

author = "Schlafstein, {Ashley J.} and Subir Goyal and Arya Amini and Karam, {Sana D.} and Saba, {Nabil F.} and Kaka, {Azeem S.} and Aiken, {Ashley H.} and Beitler, {Jonathan J.} and Stokes, {William A.}",

note = "Publisher Copyright: {\textcopyright} 2022 Wiley Periodicals LLC.",

year = "2022",

month = dec,

doi = "10.1002/hed.27204",

language = "English",

volume = "44",

pages = "2854--2864",

journal = "Head and Neck",

issn = "1043-3074",

number = "12",

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T1 - The impact of operability status on outcomes in patients with T4 larynx cancer undergoing larynx preservation

AU - Schlafstein, Ashley J.

AU - Goyal, Subir

AU - Amini, Arya

AU - Karam, Sana D.

AU - Saba, Nabil F.

AU - Kaka, Azeem S.

AU - Aiken, Ashley H.

AU - Beitler, Jonathan J.

AU - Stokes, William A.

PY - 2022/12

Y1 - 2022/12

N2 - Background: Large analyses of T4 larynx cancer (LC) have raised concerns that larynx preservation (LP) contributes to reduced survival compared with laryngectomy (LGX). The role of operability has not been previously considered as a confounder. Methods: We queried the National Cancer Database for T4M0 LC diagnosed 2004–2015. Patients were categorized as undergoing LGX, chemoradiotherapy but operable (LP-operable), and chemoradiotherapy inoperable (LP-inoperable). Overall survival (OS) was estimated by Kaplan–Meier. Cox multivariate analysis (MVA) identified variables associated with OS. Results: We identified 1405 LGX, 164 LP-operable and 1969 LP-inoperable patients. Compared with LGX, MVA demonstrated worse OS among LP-inoperable (HR 1.28 95%CI 1.17–1.40, p < 0.01) but not LP-operable patients (HR 1.12 95%CI 0.91–1.39, p = 0.28). Conclusions: LP-operable patients did not have significantly worse OS than those undergoing LGX.

AB - Background: Large analyses of T4 larynx cancer (LC) have raised concerns that larynx preservation (LP) contributes to reduced survival compared with laryngectomy (LGX). The role of operability has not been previously considered as a confounder. Methods: We queried the National Cancer Database for T4M0 LC diagnosed 2004–2015. Patients were categorized as undergoing LGX, chemoradiotherapy but operable (LP-operable), and chemoradiotherapy inoperable (LP-inoperable). Overall survival (OS) was estimated by Kaplan–Meier. Cox multivariate analysis (MVA) identified variables associated with OS. Results: We identified 1405 LGX, 164 LP-operable and 1969 LP-inoperable patients. Compared with LGX, MVA demonstrated worse OS among LP-inoperable (HR 1.28 95%CI 1.17–1.40, p < 0.01) but not LP-operable patients (HR 1.12 95%CI 0.91–1.39, p = 0.28). Conclusions: LP-operable patients did not have significantly worse OS than those undergoing LGX.

KW - laryngeal neoplasms

KW - laryngectomy

KW - organ preservation

KW - radiation

KW - radiotherapy

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ER -

The impact of operability status on outcomes in patients with T4 larynx cancer undergoing larynx preservation

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