Researchers from Emory University have reported that survival of patients with Stage III or Stage IV laryngeal cancer varies by type of treatment, gender, race, and type of health insurance. The details of this study appeared in the December, 2007 issue of the Archives of Otolaryngology – Head & Neck Surgery.¹

Laryngeal cancer affects roughly 11,300 persons per year in the U.S. and is predominantly due to smoking and heavy alcohol use. Many patients will present with advanced disease requiring sophisticated multi-modality therapy. Outcomes of treatment for advanced laryngeal cancer can be affected by medical and non-medical factors.

To explore factors that may contribute to variability in survival with advanced laryngeal cancer, researchers conducted a study among 7,019 patients with Stage III or Stage IV laryngeal cancer.² All study information was collected from the National Cancer Data Base (NCDB).

• Women had better survival than men.
• White patients had better survival than African-American patients.
• Patients with private insurance had better survival than uninsured patients or patients with Medicare or Medicaid.
• Among both Stage III and Stage IV patients, total laryngectomy resulted in better survival than radiation therapy alone.
• Compared with total laryngectomy, combined chemotherapy/radiation therapy resulted in similar survival among patients with Stage III cancer and worse survival among patients with Stage IV cancer.

A limitation of this study is that it was not a randomized clinical trial. The results could have been biased by unmeasured factors that are linked with both survival and choice of treatment. Nevertheless, the study does suggest that there are disparities in survival among patients with advanced laryngeal cancer. African American patients and patients without private insurance tend to have worse survival.

Comments: This study again shows the inadequacy of the present methods of funding medical care in this country.

Related News:

Induction Chemotherapy with Taxotere® Preserves Larynx Function (07/05/2006)

Concomitant Chemotherapy and Radiation Therapy Improve Larynx Preservation Rate in Potentially Resectable Stage III-IV Cancer of the Larynx (10/10/2002)

Concurrent Chemotherapy and Radiation Therapy Preserves Organ Function in Advanced Laryngeal Cancer (12/01/2003)

Reference:

¹ Chen AY, Halpern M. Factors predictive of survival in advanced laryngeal cancer. Archives of Otolaryngology – Head & Neck Surgery. 2007;133:1270-1276.

² American Cancer Society. Cancer Facts & Figures 2007. Available at: http://www.cancer.org/docroot/STT/STT_0.asp (Accessed January 16, 2008).