Analysis of multicentricity in supraglottic laryngeal carcinoma treated with partial laryngeal surgery

Personalized therapeutic strategies and prognosis for advanced laryngeal squamous cell carcinoma: Insights from machine learning models

PURPOSE

Despite the development of diverse treatment options, there has been an increase in mortality rates for laryngeal squamous cell carcinoma (LSCC). Our research employed survival analysis and machine learning (ML) techniques to evaluate the impact of different therapeutic options on survival and to build a prognostic model for individualized clinical decisions in advanced LSCC.

METHODS

The Surveillance, Epidemiology and End Results (SEER) database provided the data used for this study's analysis. To identify the prognostic variables for patients with LSCC, we conducted Cox regression analysis and constructed prognostic models using five machine learning (ML) algorithms to predict 5-year survival. A method of validation that incorporated the area under the curve (AUC) of the receiver operating characteristic (ROC) curve was employed to validate the accuracy and reliability of the ML models. We also investigated the role of multiple therapeutic options using Kaplan Meier (K-M) survival analysis.

RESULTS

The study included 7350 patients, of whom 2689 were diagnosed with glottic cancer (GC), 4349 with supraglottic (SuGC) and 312 with subglottic (SC). ML models identified age, sex, and stage as the most important factors that affect survival. In terms of treatment, bets survival therapeutic options for all anatomical sites was surgery and radiotherapy (RT).

CONCLUSION

Employing multimodal therapies such as surgery and radiotherapy is crucial for managing advanced-stage LSCC. Tailored approaches that consider prognostic factors such as age, sex, and tumor stage are necessary. Additionally, chemotherapy did not significantly impact overall survival, suggesting potential areas for improvement in LSCC management.

Survival analysis of laryngeal squamous cell cancer, considering different treatment modalities and other factors influencing survival - a monocentric retrospective investigation

PURPOSE

This study aimed to investigate the factors affecting laryngeal cancer survival.

METHODS

This study retrospectively analysed laryngeal cancer types, treatment options, and potential factors influencing survival.

RESULTS

77 patients (26.27%) had supraglottic laryngeal cancer, 209 (70.13%) had glottic laryngeal cancer, and 7 (3.6%) had subglottic laryngeal cancer. Common comorbidities such as type 2 diabetes mellitus, chronic obstructive pulmonary disease, and coronary disease were observed in 13.65%, 11.9%, and 22.18% of the patients, respectively. Smoking was detected in 88.05% of the patients, while 56.3% reported regular alcohol consumption. The study found that hemilaryngectomy and supraglottic horizontal resection led to significantly longer survival compared to other treatment options (i.e., total laryngectomy, supracricoid horizontal partial laryngectomy, transoral laser cordectomy, chemoradiation, chemotherapy, and radiotherapy), p = 0.000*. Glottic cancers tend to have longer survival when considering laryngeal cancer locations; however, this difference was statistically insignificant (p = 0.640). Statistical comparisons showed significantly longer survival rates for surgical treatments in stages 1 (p = 0.007*) and 4 (p = 0.007*). Factors such as coronary artery disease, higher ECOG performance status, advanced 'N' stages, and higher tumour grades were found to significantly worsen survival, as determined by a Cox proportional hazards model.

CONCLUSION

The study revealed that factors such as coronary disease, patients' functionality, 'N' stages, and tumour grade significantly impacted survival rates. Furthermore, the study found that supraglottic horizontal resection and hemilaryngectomy resulted in the longest survival. Surgical methods were associated with significantly longer survival rates in disease stages 1 and 4.