Studying the impact of young age on prognosis and treatment in laryngeal squamous cell carcinomas using the SEER database
Background Laryngeal squamous cell carcinoma (LSCC) in young patients was reported to be more aggressive and associated with poorer survival than in older patients. However, very few studies contained sufficient cases to permit meaningful statistical analysis. It is still unknown whether less aggres...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
PeerJ Inc.
2019-07-01
|
| Series: | PeerJ |
| Subjects: | |
| Online Access: | https://peerj.com/articles/7368.pdf |
| _version_ | 1797424777296609280 |
|---|---|
| author | Ruichen Li Shitong Yu Wenjia Zhu Shengzi Wang Li Yan |
| author_facet | Ruichen Li Shitong Yu Wenjia Zhu Shengzi Wang Li Yan |
| author_sort | Ruichen Li |
| collection | DOAJ |
| description | Background Laryngeal squamous cell carcinoma (LSCC) in young patients was reported to be more aggressive and associated with poorer survival than in older patients. However, very few studies contained sufficient cases to permit meaningful statistical analysis. It is still unknown whether less aggressive method like radical radiotherapy (RT) is comparable to total laryngectomy (TL) in survival rate among young patients. Methods This study extracted patient data from the surveillance, epidemiology, and end results database from 2004 to 2015. The findings for 304 patients (1.2%) below the age of 40 were compared with those for 24,827 patients (98.8%) aged 40 or older. Results The younger cohorts contained a higher proportion of female patients (33.6% vs. 19.1%, respectively), had more cases of glottic involvement (64.5% vs. 53.1%), and were less likely to have distant metastasis (0.7% vs.3.2%). A total of 5-year overall survival and cancer-specific survival rates (CSS) in the younger patients were 86.3% and 88.8%, respectively, significantly better than for older patients (53.8% and 67.6%). Significant differences were still observed when stratified for tumor stage (stage I–IV). The negative independent prognostic factors in younger patients were advanced tumor stage, degree of nodal involvement, and status of distant metastasis. Treatment with surgery and/or RT all produced excellent outcomes in stage I–IV diseases, and radical RT resulted in survival rates equal to those for TL in locally advanced LSCC among young patients (5-year CSS: 90% vs. 91.5%, p = 0.99). Conclusion LSCC is less aggressive and has significantly better survival in younger patients. For younger patients, advanced nodal involvement is the most important independent prognostic factor, and larynx preservation is comparable to TL in survival rate. |
| first_indexed | 2024-03-09T08:06:45Z |
| format | Article |
| id | doaj.art-a66aba5837094aba8858910d6dd0cf21 |
| institution | Directory Open Access Journal |
| issn | 2167-8359 |
| language | English |
| last_indexed | 2024-03-09T08:06:45Z |
| publishDate | 2019-07-01 |
| publisher | PeerJ Inc. |
| record_format | Article |
| series | PeerJ |
| spelling | doaj.art-a66aba5837094aba8858910d6dd0cf212023-12-02T23:47:54ZengPeerJ Inc.PeerJ2167-83592019-07-017e736810.7717/peerj.7368Studying the impact of young age on prognosis and treatment in laryngeal squamous cell carcinomas using the SEER databaseRuichen Li0Shitong Yu1Wenjia Zhu2Shengzi Wang3Li Yan4Department of Radiation Oncology, Eye, Ear, Nose & Throat Hospital of Fudan University, Shanghai, ChinaDepartment of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of E.N.T, Eye, Ear, Nose & Throat Hospital of Fudan University, Shanghai, ChinaDepartment of Radiation Oncology, Eye, Ear, Nose & Throat Hospital of Fudan University, Shanghai, ChinaDepartment of Radiation Oncology, Eye, Ear, Nose & Throat Hospital of Fudan University, Shanghai, ChinaBackground Laryngeal squamous cell carcinoma (LSCC) in young patients was reported to be more aggressive and associated with poorer survival than in older patients. However, very few studies contained sufficient cases to permit meaningful statistical analysis. It is still unknown whether less aggressive method like radical radiotherapy (RT) is comparable to total laryngectomy (TL) in survival rate among young patients. Methods This study extracted patient data from the surveillance, epidemiology, and end results database from 2004 to 2015. The findings for 304 patients (1.2%) below the age of 40 were compared with those for 24,827 patients (98.8%) aged 40 or older. Results The younger cohorts contained a higher proportion of female patients (33.6% vs. 19.1%, respectively), had more cases of glottic involvement (64.5% vs. 53.1%), and were less likely to have distant metastasis (0.7% vs.3.2%). A total of 5-year overall survival and cancer-specific survival rates (CSS) in the younger patients were 86.3% and 88.8%, respectively, significantly better than for older patients (53.8% and 67.6%). Significant differences were still observed when stratified for tumor stage (stage I–IV). The negative independent prognostic factors in younger patients were advanced tumor stage, degree of nodal involvement, and status of distant metastasis. Treatment with surgery and/or RT all produced excellent outcomes in stage I–IV diseases, and radical RT resulted in survival rates equal to those for TL in locally advanced LSCC among young patients (5-year CSS: 90% vs. 91.5%, p = 0.99). Conclusion LSCC is less aggressive and has significantly better survival in younger patients. For younger patients, advanced nodal involvement is the most important independent prognostic factor, and larynx preservation is comparable to TL in survival rate.https://peerj.com/articles/7368.pdfSEERYounger and older patientsLarynx preservationSurvivalLaryngeal cancer |
| spellingShingle | Ruichen Li Shitong Yu Wenjia Zhu Shengzi Wang Li Yan Studying the impact of young age on prognosis and treatment in laryngeal squamous cell carcinomas using the SEER database PeerJ SEER Younger and older patients Larynx preservation Survival Laryngeal cancer |
| title | Studying the impact of young age on prognosis and treatment in laryngeal squamous cell carcinomas using the SEER database |
| title_full | Studying the impact of young age on prognosis and treatment in laryngeal squamous cell carcinomas using the SEER database |
| title_fullStr | Studying the impact of young age on prognosis and treatment in laryngeal squamous cell carcinomas using the SEER database |
| title_full_unstemmed | Studying the impact of young age on prognosis and treatment in laryngeal squamous cell carcinomas using the SEER database |
| title_short | Studying the impact of young age on prognosis and treatment in laryngeal squamous cell carcinomas using the SEER database |
| title_sort | studying the impact of young age on prognosis and treatment in laryngeal squamous cell carcinomas using the seer database |
| topic | SEER Younger and older patients Larynx preservation Survival Laryngeal cancer |
| url | https://peerj.com/articles/7368.pdf |
| work_keys_str_mv | AT ruichenli studyingtheimpactofyoungageonprognosisandtreatmentinlaryngealsquamouscellcarcinomasusingtheseerdatabase AT shitongyu studyingtheimpactofyoungageonprognosisandtreatmentinlaryngealsquamouscellcarcinomasusingtheseerdatabase AT wenjiazhu studyingtheimpactofyoungageonprognosisandtreatmentinlaryngealsquamouscellcarcinomasusingtheseerdatabase AT shengziwang studyingtheimpactofyoungageonprognosisandtreatmentinlaryngealsquamouscellcarcinomasusingtheseerdatabase AT liyan studyingtheimpactofyoungageonprognosisandtreatmentinlaryngealsquamouscellcarcinomasusingtheseerdatabase |