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Survival prediction and treatment strategies for patients with advanced laryngeal carcinoma: a population-based study

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Abstract

Background

This study aimed at exploring high-risk factors associated with survival outcomes in patients with advanced primary laryngeal carcinoma and at developing and validating a survival-predicting model to help to select the appropriate treatment for each patient.

Methods

Data of patients with advanced primary laryngeal cancer in 2003–2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. High-risk factors were identified and integrated to build a nomogram, which was internally validated using bootstrap and externally validated with a patient cohort from China. The impact of various treatments was examined on model-defined high-, moderate- and low-risk patient groups, respectively.

Results

A total of 6070 patients were analyzed. Patients’ age, gender, tumor T stage, N stage, and differentiation grade were recognized and integrated into the model. The concordance index of this model (0.602) was significantly higher than that of the TNM staging system (0.547). The calibration curve showed a good agreement between model-predicted and actual survival outcomes. Patients were categorized into three different subgroups with incremental risks of overall mortality. The roles of three treatment strategies in these subgroups are varied.

Conclusion

In this large SEER-based study, we established a practical model to predict overall survival for patients with advanced primary laryngeal cancer. For patients identified as high-risk and moderate-risk, surgery plus adjuvant therapy is recommended, while for patients in the low-risk group, surgery alone plus regular re-examination is recommended as the primary treatment strategy.

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Acknowledgements

This study was supported by the Science and Technology Innovation Project of Shanghai Shen-kang Hospital Clinical Development Center under Grand (SHDC12015114); the Science and Technology Commission of Shanghai Municipality under Grand (16411950100); the National Natural Science Foundation of China under Grand (81772878, 30801283, 30972691); the Shanghai Science and Technology Development Funds under Grand (09QA1401000, 10QA1405900, 14411961900); the Training Program of the Excellent Young Talents of Shanghai Municipal Health System under Grand (XYQ2011055, XYQ2011015); and the Shanghai Municipal Science and Technology Foundation under Grand (11JC1410802).

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Author notes

  1. Xiaoke Zhu and Yu Heng—Co-first authors.

Authors and Affiliations

  1. Department of Otolaryngology, Shanghai Key Clinical Disciplines of otorhinolaryngology, Eye Ear Nose & Throat Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, People’s Republic of China

    Xiaoke Zhu, Yu Heng, Liang Zhou, Ming Zhang & Lei Tao

  2. Department of Ear-Nose-Throat, Pudong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China

    Wenping Li

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  1. Xiaoke Zhu
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  2. Yu Heng
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  3. Liang Zhou
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Correspondence to Wenping Li or Lei Tao.

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Zhu, X., Heng, Y., Zhou, L. et al. Survival prediction and treatment strategies for patients with advanced laryngeal carcinoma: a population-based study. Int J Clin Oncol 25, 1483–1491 (2020). https://doi.org/10.1007/s10147-020-01688-9

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  • DOI: https://doi.org/10.1007/s10147-020-01688-9

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