Survival rates of patients with stage IV laryngeal carcinoma objective

Survival Rates of Patients with Stage IV Laryngeal Carcinoma Objective: Laryngeal carcinomas are one of the most common neoplasms of upper airway and digestion systems. Stage IV laryngeal carcinomas are seen rarely, it accounts for 5% of all laryngeal carcinomas. Treatment of laryngeal carcinomas has changed since last years with conservative surgical techniques, radiotherapy, chemotherapy and organ preservation protocols. In our study, we aimed to compare the survival rates of patients with stage IV laryngeal carcinoma who had different treatment protocols.Material and Method: Charts of 92 patients who had been treated for stage IV laryngeal carcinoma in Cukurova University, Otolaryngology Department between 2001 and 2007 were investigated. Eighty patients had been operated and 12 patients had chemoradiotherapy. Patients were divided into 4 groups. Group 1 had total laryngectomy and radiothearpy (n=13) (14,1%). Group 2 had radiothearpy and/or chemoteraphy (n=12) (13%). Group 3 had total laryngectomy and neck dissection (n=16) (17%). Group 4 had total laryngectomy, neck dissection and radiothearpy (n=51) (55,5%). Overall survival rates, disease spesific survival rates and recurrence rates were compared.Results: Overall survival rate was 37% (34/92) and disease spesific survival was 41,5%. 89,5% (43/48) of patients died during the first three years. Disease spesific survival rates were 36%(4/11) at total laryngectomy and radiothearpy group, 27% (3/11) at chemoradiotherapy group, 42% (6/14) at total laryngectomy and neck dissection group and 45%(21/46) at total larngectomy, neck dissection and radiothearpy group. Mortality rate was significantly higher at patients who had only radiothearpy and/or chemotheraphy. Disease spesific survival rates of patients with T3 or T4 classification was lower than T2 classification patients. There was no significant statistical difference between patients with metastatic lymph node and patients with N0 neck status. Monotherapy group which consists of chemoradiotherapy group and total larngectomy and neck dissection group had higher recurrence rates when compared to combined group.Conclusion: Patients with stage IV laryngeal carcinoma have high mortality rates despite of modern treatment modalities. Combined therapy, age and T classification are the main factors effeting disease spesific survival. Early diagnosis is essential at patients with laryngeal carcinoma. In order to have better disease free survival, overall survival and organ preservation rates; future studies are required.Key Words: Laryngeal carcinoma, disease spesific survival, recurrence.