Staging and survival analysis for nonsquamous cell carcinomas of the larynx.

OBJECTIVE

Determine staging and comparative survival for nonsquamous cell carcinoma (SCC) of the larynx.

STUDY

DESIGN

Cross-sectional population analysis.

METHODS

: Cases of non-SCC supraglottic, glottic, and subglottic cancers were extracted from the Surveillance, Epidemiology and End Results database (1988-2003) and the staging distribution computed. For each site, Kaplan-Meier survivals were compared according to histology, T-stage, and N-stage. Survival for non-SCC cancers for each site were compared among histologies, T-stage, and N-stage as well as with age/sex/stage-matched SCC cancers to determine differences in survival.

RESULTS

One hundred forty supraglottic non-SCC cases were identified (67% male, mean age 62.0 yr) consisting of 25 neuroendocrine, 25 small cell, and 22 lymphomas (among others), with mean survivals of 44.8, 52.1, and 80.5 months, respectively. Survival was not significantly different according to histology (log-rank, P = .440) but was significantly different according to T-stage (P = .029) and N-stage (P < .001). Seventy-eight glottic non-SCC cases were identified (83% male, mean age 66.1 yr) consisting of 32 spindle cell, 13 sarcoma, and 10 small cell (among others), with mean survivals of 114.6, 89.8, and 39.2 months, respectively. Survival was not significantly different according to histology (P = .056) but was significantly different according to T-stage (P = .002) and N-stage (P = .022). Small numbers (26) precluded subglottic analysis. For both supraglottic and glottic sites including all histologies, survival was similar for matched non-SCC and SCC cases (P = .510 and P = .930, respectively).

CONCLUSIONS

Non-SCCs are more common in the supraglottic larynx. T-stage and N-stage influence survival more than histology alone for these cancers.