Clinicopathological factors influencing the outcomes of surgical treatment in patients with T4a hypopharyngeal cancer

BMC Cancer

Joo-Hyun Woo¹  Dong Hoon Lee²  Young-Hoon Joo³  Min-Sik Kim³  Sang-Yeon Kim³  Eun-Chang Choi⁴  Da-Hee Kim⁴  Min Woo Park⁵  Young-Soo Rho⁵  Eun Jae Chung⁶ 

[1] Department of Otolaryngology Head and Neck Surgery, Gachon University Gil Hospital;Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School & Chonnam National University Hwasun Hospital;Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea;Department of Otorhinolaryngology, Yonsei University, College of Medicine;Department of Otorhinolaryngology-Head and Neck Surgery, Ilsong Memorial Institute of Head and Neck Cancer, Hallym University, College of Medicine;Department of Otorhinolaryngology–Head and Neck Surgery, Seoul National University College of Medicine;

关键词: Head and neck neoplasms;    Hypopharynx;    Squamous cell carcinoma;    Surgery;    Treatment outcome;   

DOI  :  10.1186/s12885-017-3880-6

来源: DOAJ

【 摘 要 】

Abstract Background The purpose of this study was to determine prognostic factors influencing outcomes of surgical treatment in patients with T4a hypopharyngeal cancer. Methods The present study enrolled 93 patients diagnosed with T4a hypopharyngeal cancer who underwent primary surgery between January 2005 and December 2015 at six medical centers in Korea. Primary tumor sites included pyriform sinus in 71 patients, posterior pharyngeal wall in 14 patients, and postcricoid region in 8 patients. Seventy-two patients received postoperative radio(chemo)therapy. Results Five-year disease-free survival (DFS) and disease-specific survival (DSS) rates were 38% and 45%, respectively. In univariate analysis, 5-year DFS was found to have significant and positive correlations with margin involvement (p < 0.001) and extracapsular spread (p = 0.025). Multivariate analysis confirmed that margin involvement (hazard ratio (HR): 2.81; 95% confidence interval (CI): 1.49-5.30; p = 0.001) and extracapsular spread (HR: 2.08; 95% CI: 1.08-3.99; p = 0.028) were significant factors associated with 5-year DFS. In univariate analysis, cervical lymph node metastasis (p = 0.048), lymphovascular invasion (p = 0.041), extracapsular spread (p = 0.015), and esophageal invasion (p = 0.033) were significant factors associated with 5-year DSS. In multivariate analysis, extracapsular spread (HR: 2.98; 95% CI: 1.39-6.42; p = 0.005) and esophageal invasion (HR: 2.87; 95% CI: 1.38-5.98; p = 0.005) remained significant factors associated with 5-year DSS. Conclusion Margin involvement and extracapsular spread are factors influencing recurrence while extracapsular spread and esophageal invasion are factors affecting survival in patients with T4a hypopharyngeal cancer treated by primary surgery.

【 授权许可】

Unknown