title: Secular trends in the survival of patients with laryngeal carcinoma, 1995-2007.
abstract: BACKGROUND
  Recent reports suggest a decline over time in the survival of patients newly diagnosed with laryngeal cancer in spite of developments in treatment practices. Our study set out to determine whether the survival of patients with laryngeal cancer in Ontario has changed over time.
  
  
  METHODS
  This population-based cohort study of patients diagnosed with laryngeal cancer in the province of Ontario between 1995 and 2007 used data extracted from linked provincial administrative and registry databases. Its main outcomes were overall survival, laryngectomy-free survival, and survival ratio relative to an age- and sex-matched general population.
  
  
  RESULTS
  The 4298 patients newly diagnosed with laryngeal cancer during the period of interest were predominantly men (n = 3615, 84.1%) with glottic cancer (n = 2787, 64.8%); mean age in the group was 66 years (interquartile range: 59-74 years). Patient demographics did not significantly change over time. Overall, 5-year survival was 57.4%; laryngectomy-free survival was 45.4%. Comparing patients from three eras (1995-1998, 1999-2003, 2004-2007) and adjusting for age, sex, and comorbidity status, we observed no differences in overall survival or laryngectomy-free survival over time. The 5-year relative survival ratio for patients with laryngeal cancer compared with an age- and sex-matched group from the general population was 81.1% for glottic cancer and 44.5% for supraglottic cancer.
  
  
  CONCLUSIONS
  In patients with a new diagnosis of laryngeal cancer, overall and laryngectomy-free survival have remained unchanged since the mid-1990s. New methods to improve survival and the rate of laryngeal preservation in this patient population are needed.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON. ; Institute for Clinical and Evaluative Sciences, Toronto, ON. ; Department of Oncology, Western University, London, ON.
authors.forename: S D
authors.initials: SD
authors.lastname: MacNeil
authors.affiliation: Institute for Clinical and Evaluative Sciences, Toronto, ON.
authors.forename: K
authors.initials: K
authors.lastname: Liu
authors.affiliation: Institute for Clinical and Evaluative Sciences, Toronto, ON.
authors.forename: S Z
authors.initials: SZ
authors.lastname: Shariff
authors.affiliation: Institute for Clinical and Evaluative Sciences, Toronto, ON. ; Department of Epidemiology and Biostatistics, Western University, London, ON. ; Department of Family Medicine, Western University, London, ON.
authors.forename: A
authors.initials: A
authors.lastname: Thind
authors.affiliation: Department of Oncology, Western University, London, ON.
authors.forename: E
authors.initials: E
authors.lastname: Winquist
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON. ; Department of Oncology, Western University, London, ON.
authors.forename: J
authors.initials: J
authors.lastname: Yoo
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON. ; Department of Oncology, Western University, London, ON.
authors.forename: A
authors.initials: A
authors.lastname: Nichols
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON. ; Department of Oncology, Western University, London, ON.
authors.forename: K
authors.initials: K
authors.lastname: Fung
authors.affiliation: Institute for Clinical and Evaluative Sciences, Toronto, ON. ; Department of Otolaryngology-Head and Neck Surgery, Cancer Care and Epidemiology, Queen's University, Kingston, ON.
authors.forename: S
authors.initials: S
authors.lastname: Hall
authors.affiliation: Institute for Clinical and Evaluative Sciences, Toronto, ON. ; Department of Epidemiology and Biostatistics, Western University, London, ON. ; Division of Nephrology, Department of Medicine, Western University, London, ON.
authors.forename: A X
authors.initials: AX
authors.lastname: Garg
keywords: Laryngeal cancer; laryngectomy-free survival; overall survival; population-based