PURPOSE: We compared the management and outcome of supraglottic cancer in Ontario, Canada, with that in the Surveillance, Epidemiology, and End Results (SEER) Program areas in the United States. METHODS: Electronic, clinical, and hospital data were linked to cancer registry data and supplemented by chart review where necessary. Stage-stratified analyses compared initial treatment and survival in the SEER areas (n = 1,643) with a random sample from Ontario (n = 265). We also compared laryngectomy rates at 3 years in those patients 65 years and older at diagnosis. RESULTS: Radical surgery was more commonly used in SEER, with absolute differences increasing with increasing stage: I/II, 17%; III, 36%; and IV, 45%. The 5-year survival rates were 74% in Ontario and 56% in SEER for stage I/II disease (P =.01), 55.7% in Ontario and 46.8% in SEER for stage III disease (P =.40), and 28.5% in Ontario and 29.1% in SEER for stage IV disease (P =.28). Cancer-specific survival results mirrored the overall survival results with the exception of stage IV disease, for which 34.6% of Ontario patients survived their cancer compared with 38.1% in SEER (P =.10). This stage IV difference was more pronounced when we further controlled for possible cause of death errors by restricting the comparison to patients with a single primary cancer (P =.01). Three-year actuarial laryngectomy rates differed. In stage I/II, these rates were 3% in Ontario compared with 35% in SEER (P < 10(-3)). In stage III disease, the rates were 30% and 54%, respectively (P =.03), and in stage IV disease they were 33% and 64% (P =.002). CONCLUSION: There are large differences in the management of supraglottic cancer between the SEER areas of the United States and Ontario. Long-term larynx retention was higher in Ontario, where radiotherapy is widely regarded as the treatment of choice and surgery is reserved for salvage. In stages I to III, survival was similar in the two regions despite the differences in treatment policy. In stage IV, there may be a small survival advantage in the U.S. SEER areas related to the higher use of primary surgery.
PURPOSE: We compared the management and outcome of supraglottic cancer in Ontario, Canada, with that in the Surveillance, Epidemiology, and End Results (SEER) Program areas in the United States. METHODS: Electronic, clinical, and hospital data were linked to cancer registry data and supplemented by chart review where necessary. Stage-stratified analyses compared initial treatment and survival in the SEER areas (n = 1,643) with a random sample from Ontario (n = 265). We also compared laryngectomy rates at 3 years in those patients 65 years and older at diagnosis. RESULTS: Radical surgery was more commonly used in SEER, with absolute differences increasing with increasing stage: I/II, 17%; III, 36%; and IV, 45%. The 5-year survival rates were 74% in Ontario and 56% in SEER for stage I/II disease (P =.01), 55.7% in Ontario and 46.8% in SEER for stage III disease (P =.40), and 28.5% in Ontario and 29.1% in SEER for stage IV disease (P =.28). Cancer-specific survival results mirrored the overall survival results with the exception of stage IV disease, for which 34.6% of Ontario patients survived their cancer compared with 38.1% in SEER (P =.10). This stage IV difference was more pronounced when we further controlled for possible cause of death errors by restricting the comparison to patients with a single primary cancer (P =.01). Three-year actuarial laryngectomy rates differed. In stage I/II, these rates were 3% in Ontario compared with 35% in SEER (P < 10(-3)). In stage III disease, the rates were 30% and 54%, respectively (P =.03), and in stage IV disease they were 33% and 64% (P =.002). CONCLUSION: There are large differences in the management of supraglottic cancer between the SEER areas of the United States and Ontario. Long-term larynx retention was higher in Ontario, where radiotherapy is widely regarded as the treatment of choice and surgery is reserved for salvage. In stages I to III, survival was similar in the two regions despite the differences in treatment policy. In stage IV, there may be a small survival advantage in the U.S. SEER areas related to the higher use of primary surgery.
Authors: David I Rosenthal; Abdallah S R Mohamed; Randal S Weber; Adam S Garden; Parag R Sevak; Merril S Kies; William H Morrison; Jan S Lewin; Adel K El-Naggar; Lawrence E Ginsberg; Esengul Kocak-Uzel; K Kian Ang; Clifton David Fuller Journal: Cancer Date: 2015-01-13 Impact factor: 6.860
Authors: Joan L Warren; Lisa Barbera; Karen E Bremner; K Robin Yabroff; Jeffrey S Hoch; Michael J Barrett; Jin Luo; Murray D Krahn Journal: J Natl Cancer Inst Date: 2011-05-18 Impact factor: 13.506
Authors: Anna Gigli; Joan L Warren; K Robin Yabroff; Silvia Francisci; Margaret Stedman; Stefano Guzzinati; Francesco Giusti; Guido Miccinesi; Emanuele Crocetti; Catia Angiolini; Angela Mariotto Journal: J Natl Cancer Inst Monogr Date: 2013
Authors: Gordon H Guyatt; Pj Devereaux; Joel Lexchin; Samuel B Stone; Armine Yalnizyan; David Himmelstein; Steffie Woolhandler; Qi Zhou; Laurie J Goldsmith; Deborah J Cook; Ted Haines; Christina Lacchetti; John N Lavis; Terrence Sullivan; Ed Mills; Shelley Kraus; Neera Bhatnagar Journal: Open Med Date: 2007-04-14
Authors: Vishal U S Rao; Kinjal Shankar Majumdar; Anand Subash; Nabanita Banerjee; Piyush Sinha; Rachana Prasad; Akshay Kudpaje; Ravi C Nayar Journal: Indian J Otolaryngol Head Neck Surg Date: 2021-02-08