Incidence, survival, diagnostic delays and prognostic factors in laryngeal cancer

Abstract Incidence trends of laryngeal cancer in Finland were analyzed, especially in relation to survival, in a patient series of 5766 patients diagnosed in 1956–1995 and identified from the Finnish Cancer Registry. The age-adjusted incidence rate decreased from 6.5 to 3.5 per 100 000 person-years...

Full description

Bibliographic Details
Main Author: Teppo, H. (Heikki)
Format: Doctoral or Postdoctoral Thesis
Language:English
Published: University of Oulu 2003
Subjects:
Online Access:http://urn.fi/urn:isbn:9514271262
id ftunivoulu:oai:oulu.fi:isbn951-42-7126-2
record_format openpolar
spelling ftunivoulu:oai:oulu.fi:isbn951-42-7126-2 2023-07-30T04:05:50+02:00 Incidence, survival, diagnostic delays and prognostic factors in laryngeal cancer Teppo, H. (Heikki) 2003-10-31 application/pdf http://urn.fi/urn:isbn:9514271262 eng eng University of Oulu info:eu-repo/semantics/altIdentifier/pissn/0355-3221 info:eu-repo/semantics/altIdentifier/eissn/1796-2234 info:eu-repo/semantics/openAccess © University of Oulu, 2003 apoptosis diagnostic delay incidence laryngeal neoplasms prognostic factor survival info:eu-repo/semantics/doctoralThesis info:eu-repo/semantics/publishedVersion 2003 ftunivoulu 2023-07-08T19:53:44Z Abstract Incidence trends of laryngeal cancer in Finland were analyzed, especially in relation to survival, in a patient series of 5766 patients diagnosed in 1956–1995 and identified from the Finnish Cancer Registry. The age-adjusted incidence rate decreased from 6.5 to 3.5 per 100 000 person-years in males and remained unchanged among females. Only minor improvement occurred in survival. In a hospital-based material from Northern Finland (353 patients with laryngeal squamocellular carcinoma, LSCC, diagnosed in 1976–1995), the incidence among males decreased only for supraglottic cancer, diminishing the supraglottic to glottic incidence ratio from 1.4:1 to 0.5:1. Evaluation of diagnostic delays and their impact on survival and risk of recurrence was undertaken in a sample of 66 LSCC patients. In only 38% of the patients was malignancy suspected at the initial visit to a physician; infection was the most common misdiagnosis (41%). Half of the first consultations resulted in referral, whereas 17% of the patients were neither referred nor controlled. The median patient delay was 2 months and median professional delay 3 months. The latter exceeded 12 months in 17% of the patients. The delays were not significantly related to any other clinical parameter, nor were they interrelated. Professional delay of 12 months or more resulted in increased relative hazard of death (HR = 4.74, p = 0.05), equalling the effect of advanced stage (stage IV). One-third of the patients developed a recurrence. In univariate analysis, professional delay of 12 months or more increased the risk of local (p = 0.019) and neck (p = 0.019) recurrence. In a multivariate model, professional delay of 12 months or more indicated an adjusted relative hazard ratio (HR) of 4.6 for local recurrence (p = 0.02) and 9.5 for neck recurrence (p = 0.015). Immunohistochemical factors p53, apoptosis, angiogenesis and proliferation were included in a multivariate model evaluating prognostic factors of LSCC in addition to clinical and sociodemographic factors. ... Doctoral or Postdoctoral Thesis Northern Finland Jultika - University of Oulu repository
institution Open Polar
collection Jultika - University of Oulu repository
op_collection_id ftunivoulu
language English
topic apoptosis
diagnostic delay
incidence
laryngeal neoplasms
prognostic factor
survival
spellingShingle apoptosis
diagnostic delay
incidence
laryngeal neoplasms
prognostic factor
survival
Teppo, H. (Heikki)
Incidence, survival, diagnostic delays and prognostic factors in laryngeal cancer
topic_facet apoptosis
diagnostic delay
incidence
laryngeal neoplasms
prognostic factor
survival
description Abstract Incidence trends of laryngeal cancer in Finland were analyzed, especially in relation to survival, in a patient series of 5766 patients diagnosed in 1956–1995 and identified from the Finnish Cancer Registry. The age-adjusted incidence rate decreased from 6.5 to 3.5 per 100 000 person-years in males and remained unchanged among females. Only minor improvement occurred in survival. In a hospital-based material from Northern Finland (353 patients with laryngeal squamocellular carcinoma, LSCC, diagnosed in 1976–1995), the incidence among males decreased only for supraglottic cancer, diminishing the supraglottic to glottic incidence ratio from 1.4:1 to 0.5:1. Evaluation of diagnostic delays and their impact on survival and risk of recurrence was undertaken in a sample of 66 LSCC patients. In only 38% of the patients was malignancy suspected at the initial visit to a physician; infection was the most common misdiagnosis (41%). Half of the first consultations resulted in referral, whereas 17% of the patients were neither referred nor controlled. The median patient delay was 2 months and median professional delay 3 months. The latter exceeded 12 months in 17% of the patients. The delays were not significantly related to any other clinical parameter, nor were they interrelated. Professional delay of 12 months or more resulted in increased relative hazard of death (HR = 4.74, p = 0.05), equalling the effect of advanced stage (stage IV). One-third of the patients developed a recurrence. In univariate analysis, professional delay of 12 months or more increased the risk of local (p = 0.019) and neck (p = 0.019) recurrence. In a multivariate model, professional delay of 12 months or more indicated an adjusted relative hazard ratio (HR) of 4.6 for local recurrence (p = 0.02) and 9.5 for neck recurrence (p = 0.015). Immunohistochemical factors p53, apoptosis, angiogenesis and proliferation were included in a multivariate model evaluating prognostic factors of LSCC in addition to clinical and sociodemographic factors. ...
format Doctoral or Postdoctoral Thesis
author Teppo, H. (Heikki)
author_facet Teppo, H. (Heikki)
author_sort Teppo, H. (Heikki)
title Incidence, survival, diagnostic delays and prognostic factors in laryngeal cancer
title_short Incidence, survival, diagnostic delays and prognostic factors in laryngeal cancer
title_full Incidence, survival, diagnostic delays and prognostic factors in laryngeal cancer
title_fullStr Incidence, survival, diagnostic delays and prognostic factors in laryngeal cancer
title_full_unstemmed Incidence, survival, diagnostic delays and prognostic factors in laryngeal cancer
title_sort incidence, survival, diagnostic delays and prognostic factors in laryngeal cancer
publisher University of Oulu
publishDate 2003
url http://urn.fi/urn:isbn:9514271262
genre Northern Finland
genre_facet Northern Finland
op_relation info:eu-repo/semantics/altIdentifier/pissn/0355-3221
info:eu-repo/semantics/altIdentifier/eissn/1796-2234
op_rights info:eu-repo/semantics/openAccess
© University of Oulu, 2003
_version_ 1772818085985648640