European Archives of Oto-Rhino-Laryngology

, Volume 276, Issue 1, pp 193–201 | Cite as

Survival analysis of distant metastasis of laryngeal carcinoma: analysis based on SEER database

  • Yafeng Pan
  • Yuming Hong
  • Zhenyuan Liang
  • Wei ZhuangEmail author



The purpose of this study was to investigate the prognostic factors and the value of surgical treatment of patients with newly diagnosed laryngeal cancer with distant metastasis (DM).


The Surveillance, Epidemiology and End Result database (SEER) was used to analyze 446 patients with laryngeal cancer with DM at the time of initial diagnosis from 2010 to 2014.The survival prognosis of patients with DM was performed by using Kaplan–Meier and log-rank test. The prognostic factors and the effect of surgery were analyzed using the Cox regression analysis and R-language data package.


The incidence of DM was 3.21% (446/13865). Lung was the most common distant metastatic site of laryngeal cancer (62.6%), and brain metastases had the worst prognosis in patients at 2 months. T stage and brain metastasis were independent risk factors affecting the survival (P < 0.05). The hazard ratio (HR) of DM in T4 stage was nearly twice than that in T1 stage. Surgical treatment of primary and metastatic tumors can cause better survival for patients. Patients who didn’t underwent primary tumor surgery were approximately twice as likely to die from cancer as those who did. The nomogram model was constructed to visually present the 1-, 2- and 3-year survival rates of patients.


T stage, brain metastasis and surgical treatment are prognostic factors of patients with M1 stage laryngeal cancer. Surgical treatment of primary tumors and metastases can lead to better survival for patients.

Trial registration

Not applicable.


Laryngeal cancer Distant metastasis SEER Prognosis Surgical treatment 



Distant metastasis


The Surveillance, Epidemiology and End Result database


Overall survival


Cancer-specific survival


Hazard ratio

95% CI

95% confidence interval


Median survival time


Karnofsky score


Author contributions

YP: formal analysis, project administration, writing original draft, and writing review and editing. YH: design of the epidemiological investigation and formal analysis. ZL: conceptualization, supervision, data curation and validation. WZ: data curation, methodology, software, project administration, and writing review and editing.


Not applicable.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Ethics approval and consent to participate

All procedures performed in studies involving human participants conform to the standards of the institutional and national ethics committees, as well as to the 1964 Helsinki Declaration and subsequent relevant ethics. Patient informed consent is not required to extract data from the SEER database.

Consent for publication

All authors are informed and consent for publication.

Availability of data and material

All data were acquired from the SEER database. We obtained the authorization to access the SEER database with the number 14260-Nov2016.


  1. 1.
    Cosetti M, Yu GP, Schantz SP (2008) Five-year survival rates and time trends of laryngeal cancer in the US population. Arch Otolaryngol Head Neck Surg 134(4):370–379CrossRefGoogle Scholar
  2. 2.
    Siegel RL, Miller KD, Jemal A (2018) Cancer statistics, 2018. CA Cancer J Clin 68(1):7–30CrossRefGoogle Scholar
  3. 3.
    Abramson AL, Parisier SC, Zamansky MJ, Sulka M (1971) Distant metastases from carcinoma of the larynx. Laryngoscope 81(9):1503–1511CrossRefGoogle Scholar
  4. 4.
    Yücel OT, Yilmaz T, Unal OF, Turan E (1999) Distant metastases in laryngeal squamous cell carcinoma. J Exp Clin Cancer Res 18(3):285–288Google Scholar
  5. 5.
    Lahoz ZMT, Galve RF, Martínez SJ, Laguía PM (2001) Distant metastases in patients with advance laryngeal carcinoma. Acta Otorrinolaringol Esp 52(4):307–311CrossRefGoogle Scholar
  6. 6.
    Steuer CE, El-Deiry M, Parks JR, Higgins KA, Saba NF (2017) An update on larynx cancer. CA Cancer J Clin 67(1):31–50CrossRefGoogle Scholar
  7. 7.
    Spector JG, Sessions DG, Haughey BH, Chao KS, Simpson J, El MS, Perez CA (2001) Delayed regional metastases, distant metastases, and second primary malignancies in squamous cell carcinomas of the larynx and hypopharynx. Laryngoscope 111(6):1079–1087CrossRefGoogle Scholar
  8. 8.
    Yilmaz T, Hoşal S, Ozyar E, Akyol F, Gürsel B (2005) Post-operative radiotherapy in advanced laryngeal cancer: effect on local and regional recurrence, distant metastases and second primaries. J Laryngol Otol 119(10):784–790CrossRefGoogle Scholar
  9. 9.
    León X, Quer M, Orús C, del PVM, López M (2000) Distant metastases in head and neck cancer patients who achieved loco-regional control. Head Neck 22(7):680–686CrossRefGoogle Scholar
  10. 10.
    Spector GJ (2001) Distant metastases from laryngeal and hypopharyngeal cancer. ORL J Otorhinolaryngol Relat Spec 63(4):224–228CrossRefGoogle Scholar
  11. 11.
    Li XM, Di B, Shang YD, Zhou YQ, Ma HM, Cheng JM (2004) Analysis of risk factors in the prediction of distant metastases of head and neck squamous cell carcinomas. Zhonghua Er Bi Yan Hou Ke Za Zhi 39(3):171–175Google Scholar
  12. 12.
    Li X, Di B, Shang Y, Zhou Y, Cheng J, He Z (2009) Clinicopathologic risk factors for distant metastases from head and neck squamous cell carcinomas. Eur J Surg Oncol 35(12):1348–1353CrossRefGoogle Scholar
  13. 13.
    Lee DH, Kim MJ, Roh JL, Kim SB, Choi SH, Nam SY, Kim SY (2012) Distant metastases and survival prediction in head and neck squamous cell carcinoma. Otolaryngol Head Neck Surg 147(5):870–875CrossRefGoogle Scholar
  14. 14.
    Takes RP, Rinaldo A, Silver CE, Haigentz M, Woolgar JA, Triantafyllou A, Mondin V, Paccagnella D, de Bree R, Shaha AR, Hartl DM, Ferlito A (2012) Distant metastases from head and neck squamous cell carcinoma. Part I. Basic aspects. Oral Oncol 48(9):775–779CrossRefGoogle Scholar
  15. 15.
    Fortin A, Couture C, Doucet R, Albert M, Allard J, Tetu B (2001) Does histologic grade have a role in the management of head and neck cancers. J Clin Oncol 19(21):4107–4116CrossRefGoogle Scholar
  16. 16.
    Liu WW, Zeng ZY, Guo ZM, Xu GP, Yang AK, Zhang Q (2003) Distant metastases and their significant indicators in laryngeal cancer. Zhonghua Er Bi Yan Hou Ke Za Zhi 38(3):221–224Google Scholar
  17. 17.
    Matsuo JM, Patel SG, Singh B, Wong RJ, Boyle JO, Kraus DH, Shaha AR, Zelefsky MJ, Pfister DG, Shah JP (2003) Clinical nodal stage is an independently significant predictor of distant failure in patients with squamous cell carcinoma of the larynx. Ann Surg 238(3):412–421 (discussion 421–422)Google Scholar
  18. 18.
    Brouwer J, Bree R, Hoekstra OS, Langendijk JA, Castelijns JA, Leemans CR (2005) Screening for distant metastases in patients with head and neck cancer: what is the current clinical practice. Clin Otolaryngol 30(5):438–443CrossRefGoogle Scholar
  19. 19.
    Imre A, Pinar E, Dincer E, Ozkul Y, Aslan H, Songu M, Tatar B, Onur I, Ozturkcan S, Aladag I (2016) Lymph node density in node-positive laryngeal carcinoma: analysis of prognostic value for survival. Otolaryngol Head Neck Surg 155(5):797–804CrossRefGoogle Scholar
  20. 20.
    Shiono S, Kawamura M, Sato T, Okumura S, Nakajima J, Yoshino I, Ikeda N, Horio H, Akiyama H, Kobayashi K (2009) Pulmonary metastasectomy for pulmonary metastases of head and neck squamous cell carcinomas. Ann Thorac Surg 88(3):856–860CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Yafeng Pan
    • 1
  • Yuming Hong
    • 1
  • Zhenyuan Liang
    • 1
  • Wei Zhuang
    • 2
    Email author
  1. 1.Department of OtolaryngologyThe Second Affiliated Hospital of Fujian Medical UniversityQuanzhouChina
  2. 2.Department of UrologyThe Second Affiliated Hospital of Fujian Medical UniversityQuanzhouChina

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