title: The role of primary surgical treatment in young patients with squamous cell carcinoma of the larynx: a 20-year review of 34 cases.
abstract: BACKGROUND
  The aim of this study was to investigate the clinical patterns in young Chinese patients (less than 40 years old) with laryngeal squamous cell cancer (LSCC) and the outcome of primary open surgery.
  
  
  METHODS
  Thirty-four young patients, with histologically confirmed LSCC between 1985 and 2005 at Qilu Hospital and Affiliated Hospital of Weifang Medical College, who underwent primary open surgery were retrospectively evaluated according to the clinical patterns in comparison with 374 non-young patients (older than 40 years). The Kaplan-Meier method was used to calculate the survival rate. The relevance of smoking, tumor location, tumor-node-metastasis (TNM) staging, lymph node involvement, tumor size, and histological differentiation to overall survival was tested by multivariate analysis.
  
  
  RESULTS
  There was a significantly higher rate of smoking (p = 0.020) in the non-young patients compared to the young patients, but no significant difference was observed in alcohol consumption, tumor location, tumor size, TNM staging, lymph node metastasis, histological grade, and 5-year overall survival. One-year survival rates were 100%, 3-year survival rates were 79.41%, and 5-year survival rates were 67.65%. In the multivariate analysis, lymph node involvement (p = 0.006), tumor stage (p = 0.022), and tumor size (p = 0.004) proved to be significant predictors of overall survival.
  
  
  CONCLUSIONS
  The incidence of smoking was significantly higher in non-young patients compared to young patients. Primary surgery with or without radiotherapy may provide a value treatment option for young LSCC. Nodal status, tumor stage, and tumor size were the primary determinants of overall survival in multivariate analysis. These data may provide useful information for counseling and treatment planning.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of Weifang Medical College, 2428 Yunhe Road, Weifang, 261031, Shandong, People's Republic China. wangjunxisdl@163.com.
authors.forename: Junxi
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Qilu Hospital, Shandong University, Jinan, 107#, Wenhua Xi Road, Jinan, Shandong, 250012, People's Republic of China. zhaoxingguo@126.com.
authors.forename: Xingguo
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Qilu Hospital, Shandong University, Jinan, 107#, Wenhua Xi Road, Jinan, Shandong, 250012, People's Republic of China. panxinliang@yahoo.com.cn.
authors.forename: Xinliang
authors.initials: X
authors.lastname: Pan
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of Weifang Medical College, 2428 Yunhe Road, Weifang, 261031, Shandong, People's Republic China. zhaolimin@163.comp.
authors.forename: Limin
authors.initials: L
authors.lastname: Zhao
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of Weifang Medical College, 2428 Yunhe Road, Weifang, 261031, Shandong, People's Republic China. zhoujiangming@163.com.
authors.forename: Jianming
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of Weifang Medical College, 2428 Yunhe Road, Weifang, 261031, Shandong, People's Republic China. Jimin@126.com.
authors.forename: Min
authors.initials: M
authors.lastname: Ji
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult