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Laryngeal Cancer

Determining Your Prognosis

Your prognosis is a prediction of the outcome of your disease. What is the risk of succumbing to the cancer or the risk of its coming back? These are the big questions on most people’s minds after receiving a diagnosis of throat cancer. Prognosis is based on many factors, and a survival rate is an estimate based on large populations of patients who have been given a similar stage of their throat cancer. There are many specific factors that are unique to each patient that may influence treatment success.

The following aspects of the cancer may affect your prognosis.

Stage This is the most important factor that affects your chances of being cured.
Spread to Lymph NodesSpread of Cancer Cells Outside Lymph Node Capsule This goes along with stage, but even without other factors, if there is spread to lymph nodes in the neck, it’s a worse chance of cure, especially if there is evidence of spread of cancer outside of the lymph node.
Tumor Margins The ability to completely remove the tumor can be a very important factor that will influence the likelihood of being cured.
Spread into Local Structures Spread into large nerves, vessels, lymphatics or elsewhere might make your prognosis worse.

It is very difficult to discuss prognosis without understanding all the details of your cancer, and this is a conversation you’re better off having in person with your doctor.

To give you a percentage chance of cure is difficult because the SEER data groups different types of cancers together and may include patients from a long time ago. SEER stands for Surveillance Epidemiology and End Results. It is a cancer database maintained by the National Cancer Institute. This database collects statistics on patients with cancer around the country. In general, for patients with cancer of the larynx, SEER data and AJCC show the following15 Edge SB, et al. The AJCC Cancer Staging Manual – Seventh Edition. American Joint Committee on Cancer 2010.:

Survival based on AJCC Stage of cancer at the time of diagnosis:

Estimated Disease-Specific Survival at Five Years Estimated Disease-Specific Survival at Five Years Estimated Disease-Specific Survival at Five Years Estimated Disease-Specific Survival at Five Years
All Larynx Cancer (1998-1999) Supraglottis(1998-1999) Glottis(1998-1999) Subglottis(1998-1999)
Stage I 84% 59% 90% 65%
Stage II 66% 59% 74% 56%
Stage III 52% 52% 56% 47%
Stage IV 36% 34% 44% 32%

Estimated Disease-Specific Survival is the percentage of people with a specific cancer who are alive at a given time point, such as five years after diagnosis. It excludes people who may have died from a disease other than their cancer. It is probably the best estimate we have in these large national databases as to the prognosis of a particular type of cancer at each stage.

Survival based on spread of cancer at the time of diagnosis:

Estimated Disease-Specific Survival at Five Years Estimated Disease-Specific Survival at Ten Years Estimated Disease-Specific Survival at Five Years Estimated Disease-Specific Survival at Ten Years Estimated Disease-Specific Survival at Five Years Estimated Disease-Specific Survival at Ten Years
All Larynx Cancer(1988-2001) All Larynx Cancer (1988-2001) Glottic Larynx Cancer(1988-2001) Glottic Larynx Cancer (1988-2001) Supraglottic Larynx Cancer(1988-2001) Supraglottic Larynx Cancer (1988-2001)
LocalizedNo spread into lymph nodes or other parts of body 83% 72% 90% 82% 64% 45%
RegionalSpread into neck lymph nodes 49% 35% 61% 47% 44% 30%
DistantSpread to distant part of body such as lungs, bone, brain, liver 19% 11% 34% 22% 15% 10%
References

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6 Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Esophageal and Esophagogastric Junction Cancers V.2.2016. © National Comprehensive Cancer Network, Inc 2016. All rights reserved. Accessed December 7, 2016. To view the most recent and complete version of the guideline, go online to www.nccn.org.

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12 Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers V.2.2016. ©National Comprehensive Cancer Network, Inc 2016. All rights reserved. Accessed December 7, 2016. To view the most recent and complete version of the guideline, go online to www.nccn.org.

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15 Edge SB, et al. The AJCC Cancer Staging Manual – Seventh Edition. American Joint Committee on Cancer 2010.

16 Piccirillo JF, Costas I. Chapter 8: Cancer of the Larynx. Ries LAG, Young JL, Keel GE, Eisner MP, Lin YD, Horner M-J (editors). SEER Survival Monograph: Cancer Survival Among Adults: U.S. SEER Program, 1988-2001, Patient and Tumor Characteristics. National Cancer Institute, SEER Program, NIH Pub. No. 07-6215, Bethesda, MD, 2007.