Survival trends of patients with subglottic squamous cell carcinoma: A population based cohort study
Bibliographic record
Abstract
Background: Subglottic squamous cell carcinoma is a rare subsite of laryngeal cancer, which is believed to behave more aggressively and portend a worse prognosis than other laryngeal cancer subsites (supraglottis and glottis). Our objective was to utilize a population-based cancer registry to report the overall survival and laryngectomy-free survival in patients diagnosed with subglottic squamous cell carcinoma, and to examine trends in outcomes over time. We also compared overall survival in patients treated with primary laryngectomy versus radiation.\nMethods: We carried out a retrospective population-based study of patients with a new diagnosis of squamous cell carcinoma in the province of Ontario, Canada over a 15-year period (1995-2009). We identified patients with a new diagnosis of subglottic squamous cell carcinoma using the Ontario Cancer Registry. We determined demographics, comorbidity measures, staging, survival and primary treatment with laryngectomy using the linked population-based healthcare databases in Ontario. We first determined the overall survival and laryngectomy free survival of patients with subglottic cancer. In a secular trends study, we then examined the trends in overall survival and laryngectomy-free survival over the study period.\nResults: A total of 4927 cases of laryngeal carcinoma were identified, with 89 patients defined as primary subglottic carcinoma (1.8%). Among the subglottic cohort, 68 (76.4%) were male, and the mean (25th, 75th percentile) age at diagnosis was 68 (60- 77 years). The 5-year overall survival was 47.2%, while the 5-year laryngectomy-free survival was 31.5%. No differences were observed in overall survival (OS) or laryngectomy-free survival (LFS) across years over the 15-year study period (p=0.42 OS, p=0.83 LFS). Thirteen patients (15%) were treated with primary laryngectomy. Primary treatment with laryngectomy was not associated with a different risk of mortality compared with radiation.\nConclusions: The overall survival and laryngectomy-free survival of patients with subglottic carcinoma is poor and has remained stable over time (1995-2009). Primary treatment with laryngectomy does not appear to improve overall survival compared with primary radiation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".