Initial surgical therapy for advanced-stage laryngeal cancer may increase survival.

A single academic center performing a high rate of surgical therapy, including total laryngectomy, to treat advanced-stage laryngeal cancer had a higher 5-year survival rate than national levels in a small study. Dr Blake Joseph LeBlanc, of Louisiana State University (LSU) Health-Shreveport and co-authors evaluated survival rates at their institution for primary surgical treatment of advanced-stage tumor with outcomes in the National Cancer Database (NCDB).

 In an analysis of 165 patients with laryngeal cancer in the LSU Health tumor registry from 1998 to 2007, 48 (29%) had clinically early-stage (I/II) disease and 117 (71%) had advanced-stage (III/IV) disease.

Of the 117 patients with advanced-stage disease, 64 (55%) underwent primary surgical therapy to include total laryngectomy or pharyngolaryngectomy .Data from the NCDB shows the national rate of laryngectomy declined from 60% in the 1980s to 32% in 2007.

Five-year survival for stage IV was at LSU was 56% compared with 32% nationally.

The authors noted "This study suggests that initial surgical therapy for advanced-stage disease may result in increased survival compared with organ preservation".