Eur Arch Otorhinolaryngol (2010) 267:1095–1101 DOI 10.1007/s00405-009-1156-8 123 LARYNGOLOGY Survival after laryngectomy: a review of 133 patients with laryngeal carcinoma Theodoros A. Papadas · Evangelos C. Alexopoulos · Antony Mallis · Eleni Jelastopulu · Nicholas S. Mastronikolis · Panos Goumas Received: 13 July 2009 / Accepted: 5 November 2009 / Published online: 18 November 2009  Springer-Verlag 2009 Abstract Survival trends in survival for laryngeal cancer in Europe are varied. Five-year survival varied around 60–64% but numbers below 50% have been commonly reported. The aim of this study was to assess the factors inXuencing survival in patients with laryngeal cancer in our region. A total of 128 male and 5 female patients with lar- ynx cancer (91 glottic and 42 supraglottic) were treated at Patras University Hospital between March 1992 and August 2004. Except 3, all were smokers and 56 (41%) heavy alcohol users. Postsurgical staging showed that most had been classiWed at stages III (38%) and IV (49%). By histology, 31 tumors were classiWed as poorly diVerenti- ated, 78 as moderately diVerentiated and 23 as well diVer- entiated. All patients underwent laryngectomy with extension of the procedure where appropriate. Also, a total of 45 patients received adjuvant therapy (either chemother- apy or radiotherapy). Farmers, construction workers, pro- fessional drivers and mechanics and coVee shop and bar employees account for more than 70% of patients. Results showed that 64 (48.1%) patients died during the follow-up, 58 (43.6%) of them died from cause related to their disease. With a median follow-up of 25 months, the 5-year disease- free survival (DFS) was 53% and the 5-year overall sur- vival (OS) was 45%. SigniWcant prognostic factors for OS included patient age, advanced staging, heavy alcohol use and poor tumor diVerentiation while for DFS aVected mainly by poor tumor diVerentiation. We conclude that the disease stage at presentation, tumor grade and alcohol con- sumption prove to be important predictors for the OS as well as the DFS in our series. Keywords Laryngeal carcinoma · Laryngectomy · Cohort study · Survival analysis · Prognostic factors · Alcohol · Occupational exposure · Greece Introduction Laryngeal carcinoma is a disease with high incidence as it accounts for 2.4% of new malignancies worldwide every year [1]. It is estimated that in 2002 there were 139,230 new cases of laryngeal cancer worldwide [2] while in Europe alone 45,900 cases of laryngeal cancer were reported in 2006 [3]. It is the 11th commonest form of can- cer in men world-wide and it is typically considered a dis- ease of the middle aged males [4]. Despite reports that smoking cessation could prevent up to 90% of new cases of laryngeal cancer [5], it still has survival rates in the range of 73–92% for early disease stages (I and II) and 50–64% for advanced disease stages (III and IV) [6]. Chronic use of tobacco products and cigarette smoking in par- ticular, is a well-documented risk factor in laryngeal carcino- genesis [7]. Multiple studies have presented evidence on the dose-dependent eVect of smoking (in terms of cigarette con- sumption and habit duration) in the risk of developing laryn- geal cancer [8]. Moreover, recent case control studies have proposed alcohol consumption as a sole factor for development of laryngeal carcinoma, in addition to its known synergistic eVect when coupled with cigarette smoking [9]. In addition, certain occupational exposures have also been implicated in laryngeal carcinogenesis [2]. Factors inXuencing the survival of the laryngeal cancer patient include resection margins [10] and treatment modality T. A. Papadas · A. Mallis (&) · N. S. Mastronikolis · P. Goumas ENT Department, University Hospital of Patras, Patras, Greece e-mail: 6976154469@mycosmos.gr E. C. Alexopoulos · E. Jelastopulu Department of Public Health Medical School, University of Patras, Patras, Greece