Publication:

Factors involved in diagnosis delay and poor prognosis in laryngeal squamous carcinoma: a retrospective study about 86 cases

Background Squamous cell carcinoma of head and neck seems to be the seventh most common histological type worldwide with a great morbidity and mortality rates. Multiple published papers studied the overall survival of laryngeal squamous carcinoma depending on different factors. The aim of the study was to analyze the different factors that could impact the patient and the professional delays, and hence analyze factors related to poor prognosis and overall survival rates.

Methods Retrospective descriptive and analytic study between January 2015 and January 2020 in ENT-HNS department in university hospital Mohammed VI of Marrakech. All patients admitted for confirmed histologically with a primary laryngeal squamous carcinoma and who consented to this study were included in our study, grouping 86 patients.

Results Age and denial of care were the factors related to patient delay (p=0.044), medical doctors (0.030), the first consult decision (0.044) and the malpractice (0.008) were statistically related to the professional delay. The multivariate analysis with disease specific survival found that the tumor location (p=0.022), the disease staging at diagnosis (0.047), the Charlson comorbidity index (p=0.017), the patient delay and professional delay (p<0.001) were associated to a poor survival rate.

Conclusions Patient and professional delays are factors that could be controlled by emphasizing the importance of medical consult when presenting laryngeal symptoms and the essential role of primary care doctors during 1st consult and how crucial it is to make a full examination and even refer patients to specialist when malignancy is suspected.