Survival in laryngeal cancer and its predictors at Ocean Road Cancer Institute from 2008-2012

Abstract

Background: In Tanzania cancer of larynx is second in occurrence after sinonasal cancer among the HNSCC. There is no information in Tanzania about survival of laryngeal cancer patients after treatment as well as factors associated with survival. Purpose: The objective of this study was to determine the 5 years overall survival rate and factors associated with survival of laryngeal cancer patients treated at Ocean Road Cancer Institute from 2008 -2012. Material and Methods: This was retrospective study done at ORCI by reviewing records of 82 laryngeal cancer patients treated at ORCI from 2008 and 2012.All patients were followed up for 5 years. A structured questionnaire was used to extract information about characteristics of the patients and survival. For patients who were no longer attending follow up clinic a phone call was made to next of kin to the patient to inquire about the status of the patient. Five years overall survival (OS) was estimated by using the Kaplan–Meier method. Log–rank statistics was employed to identify significant prognostic factors for overall survival. Multivariate analysis was done by using Cox Proportional Hazard statistics. Association between categorical covariates was determined by using Chi-Square test and association between continuous variables determined by independent sample t-test. Results: The five years overall survival rate was 29 % and median survival time was 23 months. The main independent predictors of OS for the whole cohort in univariate analysis were T stage, presence of neck nodes, site of the tumor, level of hemoglobin and blood transfusion. High radiotherapy dose was associated with higher OS among patients treated with palliative intention. Presence of dyspnea at presentation, low performance status and N stage had borderline statistically significant association with OS. The effect of the presence of distant metastases (M stage) on survival could not be evaluated in our analysis due to the small number of patients with M1 stage. Only site of the tumor was statistically significant in multivariate analysis. Conclusion: The OS of laryngeal cancer patients is relatively lower in this study compared to those in developed countries. Early laryngeal cancer stages, glottis tumors, high hemoglobin, absence of blood transfusion prior to radiotherapy and high radiotherapy doses were associated with higher OS.