Influential Factors on Survival in Laryngeal Cancer and Treatment Modalities Comparison

Introduction: Laryngeal cancer (LC) is the most commonmalignancy in otolaryngology, comprising 30-40% of headand neck malignancies. With an increasing incidenceworldwide over the past few decades, LC has resulted insubstantial strain on the NHS. There have been notable ad-vancements in the treatment of LC over the years, particularlywith the adoption of non-surgical methods, which emergedafter the 1991 study conducted by the Veterans Affairs.Nevertheless, there has been an increase in mortality rates forhead and neck cancer by approximately 15% in the UK overthe last decade. This study aimed to evaluate the survivaloutcomes of patients with LC in our population, consideringboth the disease stage and treatment modality applied.Methods:Retrospective data were collected from 2015 to2019 for all patients who were diagnosed with primary LC atNHS Tayside. Univariate and multivariate analyses wereperformed to determine the factors associated with overallsurvival (OS) and disease-specific survival (DSS) in LC. Survivalanalysis using Kaplan-Meier curve was used to compare thetreatment modalities in different stages of LC.Results:Pa-tients with advanced LC (stages 3 and 4) had more than5 times risk of mortality compared to patients with early LC(stage 1 and 2) (DSS: HR 6.10, 95% CI: 1.52-14.61,p=0.016;OS: HR 5.52, 95% CI: 1.64-13.34,p= 0.017). In patients withstage 4 LC, laryngectomy provides better survival outcomesthan chemoradiotherapy (DSS:p=0.035;OS:p=0.046).Inaddition, DSS was double, and OS was 3 times higher forpatients who received adjuvant radiotherapy following lar-yngectomy compared to patients who underwent laryn-gectomy alone (DSS:p=0.036;OS:p=0.032).Conclusion:Our study supports that surgical treatment with adjuvantradiotherapy improves the survival outcomes of advanced LCand should be considered asfirst-line treatment in patientswho arefit for surgery. More prospective studies are neededto determine the optimal treatment approach for advancedLC with consideration of organ function, patient quality of life,and treatment-related morbidity and mortality.(c) 2025 The Author(s).Published by S. Karger AG, Basel