The two-year survival rate of laryngeal squamous cell carcinoma patients treated at Dr. George Mukhari academic hospital South Africa


  • Dikamba Muanza Department of Otorhinolaryngology, Sefako Makgatho Health Sciences University, Gauteng, South Africa
  • Monica Kotu Department of Otorhinolaryngology, Sefako Makgatho Health Sciences University, Gauteng, South Africa
  • Ian Paul Olwoch School of Medicine, University of Limpopo, Limpopo Province, South Africa



LSCC, DSS, Treatment modality


Background: The study was conducted to assess the outcome of patients diagnosed with laryngeal squamous cell carcinoma (LSCC) treated at a tertiary level hospital in South Africa. The focus was the two-year disease-specific survival (DSS) rate after diagnosis as a measuring tool for the outcomes of the disease.

Methods: A retrospective cross-sectional descriptive study was conducted at Dr. George Mukhari academic hospital (DGMAH) from 1 January 2010 to 31 December 2015. The data was collected from files of patients who were identified by clinical laryngeal symptoms, pan-endoscopy and biopsy. A total of 37 files of patients diagnosed as LSCC were included in the study.

Results: 166 hospital records were retrieved. After application of inclusion and exclusion criteria, the study excluded 129 files because of benign lesions, malignancies other than SCC on histology report, SCC from upper aero-digestive sites other than the larynx or files with incomplete information. Therefore, 37 recordswere considered for the study.

Conclusions: The study found the two-year DSS to be 43.2%. A significant contributing factor to the low two-year DSS was the advanced stage of the disease (III and IV) at the time of the presentation that was managed by palliative treatment. Advanced disease was likely due to delayed presentation to the hospital influenced by a low level of patient health knowledge, the negative impact of religious and cultural beliefs, low disposable household income coupled with high distance from home to the nearest hospital, and suboptimal screening at the primary health care level.

Author Biographies

Dikamba Muanza, Department of Otorhinolaryngology, Sefako Makgatho Health Sciences University, Gauteng, South Africa

Department of Otorhinolaryngology 

 Junior Medical specialist

Monica Kotu, Department of Otorhinolaryngology, Sefako Makgatho Health Sciences University, Gauteng, South Africa

Senior medical specialist

Department of Otorhinolaryngology

Ian Paul Olwoch, School of Medicine, University of Limpopo, Limpopo Province, South Africa

Department of Pharmacology

Head of the Department of Pharmacology and Professor


Peter M, Mathew D, Mrema A. Profile and Treatment outcome of Laryngeal Cancer Patients attended Orci from 2008 to 2011. Canc Ther Oncol Int J CTOIJMSID. 2017;5555667(54).

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424.

Perdomo S, Martin Roa G, Brennan P, Forman D, Sierra MS. Head and neck cancer burden and preventive measures in Central and South America. Cancer Epidemiol. 2016;44:S43-52.

Deng Y, Wang M, Zhou L. Global burden of larynx cancer, 1990-2017: estimates from the global burden of disease 2017 study. Ageing (Albany NY). 2020;12(3):2545-83.

Bobdey S, Jain A, Balasubramanium G. Epidemiological review of laryngeal cancer: An Indian perspective. Indian J Med Paediatr Oncol. 2015;36(3):154-60.

National Cancer Registry. Summary Statistics of Cancer Diagnosed Histologically in 2014.; 2014. Accessed June 20, 2020.

Sharma DK, Sohal BS, Bal MS, Aggarwal S. Clinico-Pathological Study of 50 Cases of Tumours of Larynx. Indian J Otolaryngol Head Neck Surg. 2013;65(S1):29-35.

De Villiers G du T, Seedat RY, Claassen AJ, Joubert G. Laryngeal carcinoma- patient profile and delay in referral. S Afr Med J. 2007;97(12):1274-5.

Cattaruzza MS, Maisonneuve P, Boyle P. Epidemiology of laryngeal cancer. Eur J Cancer Part B Oral Oncol. 1996;32B(5):293-305.

De Stefani E, Correa P, Oreggia F. Risk factors for laryngeal cancer. Cancer. 1987;60(12):3087-91.

DeSantis C, Naishadham D, Jemal A. Cancer statistics for African Americans, 2013. CA Cancer J Clin. 2013;63(3):151-66.

Onyango J, Macharia I. Delays in diagnosis, referral and management of head and neck cancer presenting at Kenyatta National Hospital, Nairobi. East Afr Med J. 2006;83(4):85-91.

Steuer CE, El-Deiry M, Parks JR, Higgins KA, Saba NF. An update on larynx cancer. CA Cancer J Clin. 2017;67(1):31-50.

Saini AT, Genden EM MU. Sociodemographic disparities in choice of therapy and survival in advanced laryngeal cancer. Am J Otolaryngol. 2016;37(2):65-9.

Gourin CG, Conger BT, Sheils WC, Bilodeau PA, Coleman TA, Porubsky ES. The effect of treatment on survival in patients with advanced laryngeal carcinoma. Laryngoscope. 2009;119(7):1312-7.

Forastiere AA, Zhang Q, Weber RS. Long-term results of RTOG 91-11: a comparison of three nonsurgical treatment strategies to preserve the larynx in patients with locally advanced larynx cancer. J Clin Oncol. 2013;31(7):845-52.

Akduman D, Karaman M, Uslu C. Larynx cancer treatment results: Survive and quality of life assessment. J ear, nose, throat. 2010;20(1):25-32.

Adoga A, Ma’an E. The challenges of treating laryngeal carcinoma in Jos, Nigeria. J West African Coll Surg. 2011;1(2):63-75.

Mvouni Oyono S, Njock R, Fouda A, Moune A, Bengono G. Management of laryngeal cancer in an ENT Service in subSaharan Africa. Sante. 2006;16(2):109-12.

McIntosh JR. Understanding Cancer: An Introduction to the Biology, Medicine, and Societal Implications of This Disease. CR Press. Gerland Science Book. 2019.

Megwalu UC, Sikora AG. Survival Outcomes in Advanced Laryngeal Cancer. JAMA Otolaryngol Neck Surg. 2014;140(9):855.

Lewis JS. Not Your Usual Cancer Case: Variants of Laryngeal Squamous Cell Carcinoma. Head Neck Pathol. 2011;5(1):23-30.

Wolf G, Group VALCS. Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med. 1991;324(24):1685-90.

Zhang S-Y, Lu Z-M, Luo X-N. Retrospective analysis of prognostic factors in 205 patients with laryngeal squamous cell carcinoma who underwent surgical treatment. PLoS One. 2013;8(4):e60157.

Roos ME, Sherriff A, Nel M, Seedat RY. Laryngeal squamous cell carcinoma at a south African referral hospital. Egypt J Ear, Nose, Throat Allied Sci. 2019;20(2):53-9.

Onotai L, Nwosu C. Laryngeal tumours: clinical features and management challenges as seen in two centres in Port Harcourt, Nigeria. Port Harcourt Med J. 2016;10(1):31.

Inverso G, Mahal BA, Aizer AA, Donoff RB, Chau NG, Haddad RI. Marital status and head and neck cancer outcomes. Cancer. 2015;121(8):1273-8.

Choi SH, Terrell JE, Fowler KE. Socioeconomic and Other Demographic Disparities Predicting Survival among Head and Neck Cancer Patients. PLoS One. 2016;11(3):e0149886.

Lyhne NM, Johansen J, Kristensen CA. Incidence of and survival after glottic squamous cell carcinoma in Denmark from 1971 to 2011-A report from the Danish. Head and Neck Cancer Group. Eur J Cancer. 2016;59:46-56.

Bhattacharjee A, Bhattacharyya T, Santhosh S, Kiran P, Sanudev Sadanandan VP, Geetha M. Impact of waiting time for treatment on survival in patients undergoing radiotherapy for head and neck cancer. J Cancer Policy. 2017;13:1-4.

Naghavi AO, Echevarria MI, Strom TJ, Abuodeh YA, Ahmed KA, Venkat PS et al. Treatment delays, race, and outcomes in head and neck cancer. Cancer Epidemiol. 2016;45:18-25.

Ayo-Yusuf OA, Olutola BG. ‘Roll-your-own’ cigarette smoking in South Africa between 2007 and 2010. BMC Public Health. 2013;13(1):597.

Fortin A, Wang CS, Vigneault É. Influence of Smoking and Alcohol Drinking Behaviors on Treatment Outcomes of Patients with Squamous Cell Carcinomas of the Head and Neck. Int J Radiat Oncol. 2009;74(4):1062-9.

Wang H, Wolock TM, Carter A. Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980-2015: the Global Burden of Disease Study 2015. Lancet HIV. 2016;3(8):e361-87.

McLemore MS, Haigentz M, Smith RV. Head and neck squamous cell carcinomas in HIV-positive patients: A preliminary investigation of viral associations. Head Neck Pathol. 2010;4(2):97-105.

Shiels MS, Cole SR, Kirk GD, Poole C. A meta-analysis of the incidence of non-AIDS cancers in HIV-infected individuals. J Acquir Immune Defic Syndr. 2009;52(5):611-22.

Engsig FN, Gerstoft J, Kronborg G. Head and neck cancer in HIV patients and their parents: a Danish cohort study. Clin Epidemiol. 2011;3:217-7.

Coghill AE, Shiels MS, Suneja G, Engels EA. Elevated Cancer-Specific Mortality Among HIV-Infected Patients in the United States. J Clin Oncol. 2015;33(21):23762383.






Original Research Articles