{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T16:08:26Z","timestamp":1789661306438,"version":"4.0.1"},"reference-count":23,"publisher":"Wiley","issue":"18","license":[{"start":{"date-parts":[[2016,5,31]],"date-time":"2016-05-31T00:00:00Z","timestamp":1464652800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2016,9,15]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>The treatment of patients with advanced stage laryngeal cancer includes surgery or concurrent chemoradiation (CRT). Although CRT has become more common in recent years, to the authors' knowledge, the effectiveness of complete CRT in improving survival over surgery has not been studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The authors examined patients in the Surveillance, Epidemiology, and End Results (SEER)\u2010Medicare claims\u2010linked data set with locoregional laryngeal cancer who were diagnosed between 1997 and 2007. Multivariate Cox proportional hazard analyses were conducted to compare overall and cause\u2010specific 5\u2010year survival rates between treatment modalities, adjusting for patient sociodemographic and clinical characteristics. A propensity score\u2010matched subcohort also was used to compare survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Of the 3212 patients in the study cohort, 42% underwent surgery and 18% underwent CRT. Only approximately one\u2010quarter of patients who were treated with CRT completed the courses. In adjusted analyses, the authors were unable to reject the null hypothesis of no difference in 5\u2010year all\u2010cause or cause\u2010specific mortality risk between patients treated with surgery and patients undergoing complete CRT (hazards ratio, 1.25 [95% confidence interval, 0.91\u20101.71;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.16] and hazard ratio, 1.41 [95% confidence interval, 0.9\u20102.2;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.14], respectively). Older age, not currently married, Medicaid eligibility, and prior cancer history were found to be associated with a higher risk of mortality (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>\n                      Patients with advanced laryngeal cancer who underwent complete CRT were found to have overall and cause\u2010specific survival rates similar to those of patients undergoing surgery. However, a substantial percentage of patients who initiated CRT did not complete the course. Although CRT provides organ preservation, the benefits and trade\u2010offs of CRT and total laryngectomy should be discussed fully with patients. The importance of completing the full course of CRT should be emphasized.\n                      <jats:bold>\n                        <jats:italic>Cancer<\/jats:italic>\n                        2016\n                      <\/jats:bold>\n                      . \u00a9\n                      <jats:italic>2016 American Cancer Society<\/jats:italic>\n                      .\n                      <jats:italic>\n                        <jats:bold>Cancer 2016;122:2845\u20132856.<\/jats:bold>\n                        \u00a9 2016 American Cancer Society\n                      <\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.30122","type":"journal-article","created":{"date-parts":[[2016,5,31]],"date-time":"2016-05-31T11:17:07Z","timestamp":1464693427000},"page":"2845-2856","source":"Crossref","is-referenced-by-count":30,"title":["Comparative effectiveness of surgical and nonsurgical therapy for advanced laryngeal cancer"],"prefix":"10.1002","volume":"122","author":[{"given":"Chun Chieh","family":"Lin","sequence":"first","affiliation":[{"name":"Surveillance and Health Services Research American Cancer Society Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey A.","family":"Fedewa","sequence":"additional","affiliation":[{"name":"Surveillance and Health Services Research American Cancer Society Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kara K.","family":"Prickett","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Emory University School of Medicine Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin A.","family":"Higgins","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Winship Cancer Institute, Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy Y.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Emory University School of Medicine Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,5,31]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2011.171"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000236095.97947.26"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-009-0596-4"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2009.108"},{"key":"e_1_2_8_6_1","volume-title":"Using the Phreg Procedure to Analyze Competing\u2010Risks Data","author":"So 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