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Surgery Offers Best Chance in Laryngeal Cancer

Race, type of health coverage also factors predicting survival

TUESDAY, Dec. 18 (HealthDay News) -- In patients with stage IV laryngeal cancer, total laryngectomy is associated with better chance of survival than radiation therapy alone or combined chemotherapy and radiation, according to research published in the December Archives of Otolaryngology - Head & Neck Surgery.

Amy Y. Chen, M.D., of Emory University and Michael Halpern, M.D., Ph.D., of the American Cancer Society in Atlanta, analyzed data on 7,019 adults with stage III or IV laryngeal cancer who were treated with total laryngectomy, radiation therapy, or chemotherapy and radiation (chemo-RT).

In patients with stage III disease, survival was similar with total laryngectomy and chemo-RT, and lower with radiation therapy alone. In stage IV disease, total laryngectomy was associated with better survival compared to the other two treatments. In addition, black patients had a lower likelihood of survival compared to whites, and patients who were uninsured or insured with government health coverage had a greater risk of mortality than those with private insurance.

"Although our results demonstrate nearly equivalent efficacy for chemo-RT and total laryngectomy for T3 and stage III disease, we show significant differences in survival for all patients with advanced laryngeal cancer, thus indicating that much of the difference is attributable to stage IV disease and not to stage III disease. The treatment decision (chemo-RT versus total laryngectomy) for stage III and T3 disease should be based on other factors, such as patient preference, performance status, and function, rather than on survival, especially because there does not seem to be notable differences in this regard," the authors conclude.

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