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CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2022; 26(03): e370-e379
DOI: 10.1055/s-0041-1726042
Original Research

Treatment Results for Stage III Laryngeal Cancer: Analysis of a Populational Database Using Propensity Scores

Hugo Fontan Köhler 
1   Department of Head and Neck Surgery and Otolaryngology, A C Camargo Cancer Center, São Paulo, SP, Brazil
,
Genival Barbosa de Carvalho 
1   Department of Head and Neck Surgery and Otolaryngology, A C Camargo Cancer Center, São Paulo, SP, Brazil
,
Luiz Paulo Kowalski 
1   Department of Head and Neck Surgery and Otolaryngology, A C Camargo Cancer Center, São Paulo, SP, Brazil
2   Department of Head and Neck Surgery, Universidade Estadual Paulista, São Paulo, SP, Brazil
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Abstract

Introduction Treatment of stage III laryngeal cancer suffered a major paradigm change with surgery being substituted by radiation therapy with chemotherapy.

Objective To evaluate the oncological outcome of different treatment modalities for stage III laryngeal cancer using a population database.

Methods A population database representing patients treated in the state of São Paulo, Brazil, was analyzed. Demographic, clinical and treatment variables were included, and the outcomes of interest were disease-specific and overall survival. Propensity score with nearest neighbor matching was used to compensate for imbalances in treatment groups.

Results We retrieved data from 1,804 patients. In multivariate analysis, age, female gender, payment source, clinical N stage (cN) stages, and treatment modality were significant for disease-specific and overall survival. Patients submitted to surgery treatment had a significantly better disease-specific (p < 0.001) and overall survival (p < 0.001) compared with chemoradiation. Propensity score matching was based on cN stage, gender, age, topography, and payment modality, and allowed the pairing of 685 patients from each treatment modality. There was a significant difference in disease-specific survival favoring surgery-based treatment (p = 0.017).

Conclusion The treatment choice has a significant impact on survival in patients with stage III laryngeal cancer with surgery-based treatment being superior to chemoradiotherapy (CRT).

Keywords

laryngeal neoplasms - propensity score - prognosis - surgery - radiotherapy


Publication History

Received: 02 June 2020

Accepted: 21 November 2020

Article published online:
03 November 2021

© 2021. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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