The role of primary surgical treatment in young patients with squamous cell carcinoma of the larynx: a 20-year review of 34 cases

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.