Treatment patterns and survival outcomes of advanced hypopharyngeal squamous cell carcinoma

World Journal of Surgical Oncology

Kai-Ping Chang¹  Yao-Te Tsai²  Ming-Shao Tsai²  Cheng-Ming Hsu²  Chih-Yen Chien³  Yi-Chan Lee⁴  Wen-Cheng Chen⁵  Chia-Hsuan Lai⁵  Meng-Hung Lin⁶ 

[1] Department of Otolaryngology–Head and Neck Surgery, Linkou Chang Gung Memorial Hospital;Department of Otorhinolaryngology-Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital;Department of Otorhinolaryngology-Head and Neck Surgery, Kaohsiung Chang Gung Memorial Hospital;Department of Otorhinolaryngology-Head and Neck Surgery, Keelung Chang Gung Memorial Hospital;Department of Radiation Oncology, Chiayi Chang Gung Memorial Hospital;Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital;

关键词: Head and neck;    Cancer;    Hypopharynx;    Squamous cell carcinoma;    Prognosis;   

DOI  :  10.1186/s12957-020-01866-z

来源: DOAJ

【 摘 要 】

Abstract Background This study evaluated the treatment outcomes of the primary surgery (PS) or concurrent chemoradiotherapy (CCRT) as the initial treatment for hypopharyngeal squamous cell carcinoma (HPSCC). Methods This retrospective cohort study included patients with stages III–IV HPSCC from four tertiary referral centers consecutively enrolled from 2003 to 2012; of them, 213 (32.6%) and 439 (67.4%) had received PS and CCRT as their primary treatments, respectively. The 5-year overall survival (OS) and disease-free survival (DFS) rates were analyzed using the Kaplan–Meier method and Cox regression models. Results In patients undergoing PS and CCRT, OS rates were 45.0% and 33.1% (p < 0.001), respectively, and DFS rates were 36.2% and 28.9% (p = 0.003), respectively. In subgroup analysis, in patients with stage IVA HPSCC, PS was associated with higher OS rate (p = 0.002), particularly in those with T4 or N2 classification (p = 0.021 and 0.002, respectively). Multivariate analysis indicated that stage IVA HPSCC, stage IVB HPSCC, and CCRT were independent adverse prognostic factors for OS rate (p = 0.004, < 0.001, and 0.014, respectively). Furthermore, in patients with stage IVA HPSCC aged ≥ 65 years and with N2 classification, CCRT was significantly associated with lower OS rates than was PS (p = 0.027 and 0.010, respectively). Conclusions In patients with advanced HPSCC, PS was significantly associated with better prognosis than CCRT. PS could be a favorable primary treatment modality for the management of patients with stage IVA HPSCC, particularly those aged ≥ 65 years and with T4 and N2 classification.

【 授权许可】

Unknown