อัตรารอดชีพ 5 ปี ของผู้ป่วยมะเร็งกล่องเสียงในระยะลุกลามอวัยวะข้างเคียงที่ได้รับการผ่าตัดกล่องเสียงออกทั้งหมดในโรงพยาบาลกระทุ่มแบน

Weerapol  Kimsiri

Authors

Weerapol Kimsiri Krathumbaen Hospital

Keywords:

Survival rate, total laryngectomy, laryngeal cancer

Abstract

Objective: To investigate the 5-year survival rate of patients with advanced stage laryngeal cancer who underwent total laryngectomy at Krathum Baen Hospital.

Method: This study is a retrospective cohort study that examines historical data collected from medical records. The sample group consists of medical records of patients with laryngeal cancer who underwent laryngectomy from January 1, 2018, to December 31, 2022, at Krathumban Hospital, Samut Sakhon Province, with a total of 30 patients. The patients were followed up until December 2027. The purposive sampling method was used, selecting only patients with laryngeal cancer in the stage of invasion to adjacent organs who had not received radiation therapy before and had undergone total laryngectomy at Krathumban Hospital, and who continued to have follow-up records. Data collection was done through a medical record data sheet that included gender, age, cancer stage, history of postoperative radiation therapy, time to recurrence after surgery, time to second primary cancer after surgery, and time to death after surgery. The data were analyzed using Kaplan-Meier (KM) survival curves, and factors associated with survival were analyzed using Cox's proportional hazard regression.

Results: The 5-year survival rate of patients with advanced stage laryngeal cancer who underwent total laryngectomy at Krathum Baen Hospital was 60%. Cox’s proportional hazards regression analysis indicated that patients who did not complete postoperative radiotherapy had a 14.88 times higher risk of death compared to those who completed the treatment. Additionally, patients without recurrence after surgery had a 91% lower risk of death compared to those who experienced recurrence.

Conclusion: Adjuvant postoperative radiotherapy significantly improved survival rates in patients with advanced laryngeal cancer. Furthermore, cancer recurrence significantly reduced survival rates in these patients.

Keywords: Survival rate, total laryngectomy, laryngeal cancer

References

Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin. 2022;72(1):7-33. Doi: 10.3322/caac.21708.

Lee YG, Kang EJ, Keam B, Choi JH, Kim JS, Park KU, et al. Treatment strategy and outcomes in locally advanced head and neck squamous cell carcinoma: a nationwide retrospective cohort study (KCSG HN13-01). BMC Cancer. 2020;20(1):813. Doi: 10.1186/s12885-020-07297-z.

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Head and Neck Cancers, Version 1.2021 [Internet]. Fort Washington (PA): NCCN; 2021 [cited 2025 Mar. 23]. Available from: https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1438

Forastiere AA, Ismaila N, Lewin JS, Nathan CA, Adelstein DJ, Eisbruch A, et al. Use of larynx-preservation strategies in the treatment of laryngeal cancer: American Society of Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol. 2018;36(11):1143-69. Doi: 10.1200/JCO.2017.75.7385.

Bernier J, Cooper JS, Pajak TF, van Glabbeke M, Bourhis J, Forastiere A, et al. Defining risk levels in locally advanced head and neck cancers: a comparative analysis of concurrent postoperative radiation plus chemotherapy trials of the EORTC (#22931) and RTOG (#9501). Head Neck. 2005;27(10):843-50. Doi:10.1002/hed.20279.

Wang Q, Liu Y, Hu G, Wang R, Zhao Y, Zhang M. The survival rate and larynx preservation in elderly cancer patients who received surgical operation: a retrospective cohort study. International Journal of Surgery. 2016;36:342-6. Doi:10.1016/j.ijsu.2016.11.073

Sangariyavanich E. Clinical Outcome After Total Laryngectomy in Laryngeal and Hypopharyngeal Carcinoma. SRIMEDJ [internet]. 2020 Sep. 8 [cited 2025 Mar. 23];35(5):568-75. available from: https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/246692

Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2021. CA Cancer J Clin. 2021;71(1):7-33. Doi: 10.3322/caac.21654.

Avdulla CS, Mastronikolis NS, Tachirai N, Leotsinidis M, Jelastopulu E. Survival analysis of elderly patients with laryngeal cancer after total laryngectomy: a retrospective cohort study. Cureus. 2024 May 21;16(5):e60792. Doi:10.7759/cureus.60792.

American Cancer Society. Laryngeal and hypopharyngeal cancers survival rates, by stage. [Internet] [cited 2025 Mar. 23]. Available from: https://www.cancer.org/cancer/types/laryngeal-and-hypopharyngeal-cancer/detection-diagnosis-staging/survival-rates.html

Chen X, Li P, Zhang X, Zhang S, Liu M. Survival outcomes in patients with T3-4aN0M0 glottic laryngeal squamous cell carcinoma treated with total laryngectomy: A SEER-based study. Cancer Med. 2022;11(21):4110–20. Doi:10.1002/cam4.4634.

Hoffman HT, Porter K, Karnell LH, Cooper JS, Weber RS, Langer CJ, et al. Laryngeal cancer in the United States: Changes in demographics, patterns of care, and survival. Laryngoscope. 2006;116:1–13. Doi: 10.1097/01.mlg.0000236095.97947.26.

Chu PY, Chang SY, Huang JL, Tai SK. Different patterns of second primary malignancy in patients with squamous cell carcinoma of larynx and hypopharynx. Am J Otolaryngol. 2010;31:168–74. Doi: 10.1016/j.amjoto.2008.12.004.

Lu D, Zhou X, Sun H, Zeng B, Fu J, Gong J, et al. Risk of second primary cancer in patients with head and neck squamous cell carcinoma: a systematic review and meta-analysis. Clin Oral Investig. 2023;27(9):4897-910. Doi: 10.1007/s00784-023-05066-3.

Di Martino E, Sellhaus B, Hausmann R, Minkenberg R, Lohmann M, Esthofen MW. Survival in second primary malignancies of patients with head and neck cancer. J Laryngol Otol. 2002;116(10):831-8. Doi: 10.1258/00222150260293664.