Nonsquamous cell laryngeal cancers: Incidence, demographics, care patterns, and effect of surgery

Laryngoscope. 2019 Nov;129(11):2496-2505. doi: 10.1002/lary.27785. Epub 2019 Jan 10.

Abstract

Objectives: To analyze the incidence and clinical profile of nonsquamous cell (non-SCC) laryngeal carcinomas and to analyze the effect of surgery on survival.

Study design: A retrospective analysis of the National Cancer Database (2004-2014).

Methods: Adult patients with non-SCC laryngeal cancers were divided into six major histological subtypes. A descriptive clinical profile was obtained for non-SCC patients, and multivariate regressions were performed to analyze the effect of surgery on survival within the non-SCC cohort.

Results: We identified 878 cases of non-SCC laryngeal cancers, representing 1.02% of all malignant laryngeal cancers. Neuroendocrine tumors and bone/cartilage sarcomas made up the largest groups (37.02% and 32.35%, respectively). Metastasis (M) was higher in neuroendocrine tumors, representing 19.1% of those with known clinical M stages. Of those treated, the majority of patients with bone/cartilage sarcomas (80.9%) and minor salivary gland tumors (82.6%) received surgery as part of their treatment. Survival varied significantly based upon histology, with bone/cartilage sarcomas having the highest 5-year survival at 90.4%, and neuroendocrine tumors exhibiting the poorest 5-year survival at 25.7%. Multivariate analyses found surgery to be significantly associated with improved survival (hazard ratio: 0.679; 95% confidence interval: 0.472-0.976; P = 0.036). The specific surgical method (i.e., local excision vs. partial vs. total laryngectomy) did not have any effect on survival.

Conclusion: Approximately 1% of all malignant laryngeal cancers are non-SCC in origin. At presentation, neuroendocrine tumors have the highest rate of distant metastasis and have the worst prognosis of the non-SCC cancers. Most non-SCC patients received surgery as part of their treatment regimen.

Level of evidence: NA. Laryngoscope, 129:2496-2505, 2019.

Keywords: National Cancer Database; Nonsquamous cell laryngeal cancers; head and neck cancer; laryngeal cancer.

Publication types

  • Evaluation Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Databases, Factual
  • Female
  • Humans
  • Incidence
  • Laryngeal Neoplasms / mortality*
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / surgery
  • Laryngectomy / methods
  • Laryngectomy / mortality*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Metastasis
  • Neuroendocrine Tumors / mortality
  • Neuroendocrine Tumors / surgery
  • Proportional Hazards Models
  • Regression Analysis
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome
  • Young Adult