title: Time trends in T3 to T4 laryngeal cancer: a population-based long-term analysis.
abstract: BACKGROUND
  A decline in laryngectomies and survival in laryngeal cancer has been reported, especially among patients with advanced tumors.
  
  
  METHODS
  Of 1058 patients with laryngeal cancer diagnosed from 1978 to 2007 in the Uppsala-Örebro region in Sweden, 263 T3 to T4 tumors treated with curative intent were studied retrospectively. Two time periods were defined, 1978 to 1992 and 1993 to 2007.
  
  
  RESULTS
  Glottic tumors decreased constituting 68.6% of cases in 1978 to 1992 and 47.9% in 1993 to 2007. Laryngectomies were performed in 38.8% and 34.5% in the corresponding time periods. The use of laryngectomy was not strongly prognostic. A decline in overall survival (OS) over time could only be identified for the first year of follow-up. Chemotherapy was only used in a minority of cases.
  
  
  CONCLUSIONS
  The marked decrease of glottic site may mark a shift in etiology. Laryngectomy was not strongly associated with improved survival. The absence of improved survival calls for intensified research.
authors.affiliation: Department of Oncology, Örebro University Hospital, Örebro, Sweden.
authors.forename: Johan A
authors.initials: JA
authors.lastname: Reizenstein
authors.forename: Lars
authors.initials: L
authors.lastname: Holmberg
authors.forename: Michael
authors.initials: M
authors.lastname: Bergqvist
authors.forename: Arne
authors.initials: A
authors.lastname: Linder
authors.forename: Simon
authors.initials: S
authors.lastname: Ekman
authors.forename: Britta
authors.initials: B
authors.lastname: Lödén
authors.forename: Marit
authors.initials: M
authors.lastname: Holmqvist
authors.forename: Karin
authors.initials: K
authors.lastname: Hellström
authors.forename: Mattias
authors.initials: M
authors.lastname: von Beckerath
authors.forename: Erik
authors.initials: E
authors.lastname: Blomquist
authors.forename: Stefan N
authors.initials: SN
authors.lastname: Bergström
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D005931:Glottis; D006801:Humans; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D013548:Sweden; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents
keywords: cancer; glottic; laryngeal; laryngectomy; supraglottic