The survival outcome and gender difference of elderly females with laryngeal cancer

Background: To analyze the gender differences in epidemiology and survival of elderly females with laryngeal cancer, and possible clinical countermeasures to reduce the differences. Methods Patients aged ≥ 65 years with laryngeal cancer in the Surveillance, Epidemiology, and End Results database from 2010–2018 were collected. The Kaplan-Meier method was performed to calculate overall survival (OS) and evaluate univariate factors affecting OS. Multivariate Cox regression analysis was conducted on variables with P-value < 0.05. Propensity score matching was applied to reduce the effects of confounding factors. Gender differences were analyzed by the chi-squared test. Results The gender difference was significant in survival prognosis in the elderly population, with males having significantly better OS than females. The gender difference was mainly manifested in stage I. Gender, age at diagnosis, marital status, tumor site, and treatment modality were prognostic factors affecting the OS of stage I patients. Compared to male patients, females were diagnosed at an older age, with more singles, more supraglottic types, and more likely to undergo lymph node dissection (LND). The gender difference of OS in radiotherapy (RT) group was the most obvious, and the prognosis of organ preservation surgery (OPS) group was comparable to that of the OPS + RT group, but both better than that of the RT group. Conclusion The gender difference in survival was significant in elderly patients with stage I laryngeal cancer. To narrow gender differences: LND should be emphasized in females with supraglottic laryngeal cancer; OPS should be considered for females for a better prognosis and combination therapy was not advocated; Age at diagnosis ≥ 85 years and single females should receive more attention.