Short-and long-term outcomes of laryngeal cancer care in the elderly

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


Objectives/Hypothesis To examine associations between pretreatment variables, short-term and long-term swallowing and airway impairment, and survival in elderly patients treated for laryngeal squamous cell cancer (SCCA). Study Design Retrospective analysis of Surveillance, Epidemiology, and End Results-Medicare data. Methods Longitudinal data from 2,370 patients diagnosed with laryngeal SCCA from 2004 to 2007 were evaluated using cross-tabulations, multivariate logistic regression, and survival analysis. Results Dysphagia (odds ratio [OR] = 1.5 [1.2-1.7]), weight loss (OR = 1.3 [1.1-1.6]), esophageal stricture (OR = 3.8 [2.5-5.9]), airway obstruction (OR = 1.9, [1.6-2.3]), tracheostomy (OR = 1.5 [1.2-1.9]), and pneumonia (OR = 1.8 [1.4-2.2]) increased 1 year after treatment. The odds of airway obstruction, esophageal stricture, and pneumonia increased over subsequent years, with significantly increased risk at 5 years for airway obstruction (OR = 3.3 [1.8-5.8]) and pneumonia (OR = 5.2 [2.5-10.7]). Pretreatment dysphagia, chemoradiation, and salvage surgery were significant predictors of long-term dysphagia, weight loss, tracheostomy, and gastrostomy, with pretreatment dysphagia and salvage surgery also associated with pneumonia. Surgery and postoperative radiation was associated with long-term dysphagia (OR = 1.4 [1.0-1.9]) but reduced odds of long-term pneumonia (OR = 0.7 [0.5-0.9]). Long-term dysphagia, gastrostomy or tracheostomy dependence, weight loss, airway obstruction, and pneumonia were associated with poorer survival, with pneumonia associated with the greatest risk of death at 5 years (hazard ratio = 2.6 [2.4-2.9]). Conclusions Airway and swallowing impairment is common after laryngeal SCCA treatment in elderly patients, increases over time, and is associated with poorer survival-with pneumonia associated with the highest risk of long-term mortality. Patients with pretreatment dysphagia, initial treatment with chemoradiation, and salvage surgery represent a high-risk group with an increased risk of disability and death.

Original languageEnglish (US)
Pages (from-to)924-933
Number of pages10
Issue number4
StatePublished - Apr 1 2015


  • Laryngeal cancer
  • SEER-Medicare
  • aspiration
  • chemotherapy
  • dysphagia
  • elderly
  • gastrostomy
  • outcomes
  • pneumonia
  • radiation
  • squamous cell cancer
  • surgery
  • survival
  • treatment

ASJC Scopus subject areas

  • Otorhinolaryngology


Dive into the research topics of 'Short-and long-term outcomes of laryngeal cancer care in the elderly'. Together they form a unique fingerprint.

Cite this