Has Hypopharyngeal SCCa Survival Paralleled Laryngeal SCCa?

Abstract

Objective: To determine if: 1) the national trend of decreased survival of laryngeal cancer patients has also been seen in patients with squamous cell carcinoma of the hypopharynx, 2) to determine which subsets of hypopharyngeal cancer are most affected, and 3) to analyze factors that may contribute to survival. Method: The Surveillance, Epidemiology and End Results (SEER) Database of the National Cancer Institute was analyzed for this study. Records of 6916 patients with squamous cell carcinoma (SCCa) of the hypopharynx between 1973 and 2003 were selected for review. Results: Overall 5-year survival rates for hypopharyngeal cancer have improved since 1973. Average survival of MO hypopharyngeal cancer patients was 83% in those diagnosed since 1990, compared to 75% before 1990 ( P < .0001). Since 2000, survival has averaged 86%. Since 1990, more patients have been treated with radiation only (1973-89, 42.3% vs 1990-2003, 49.9%) as opposed to combined surgical and radiation therapy (1973-89, 43.6% vs 1990-2003, 42.9%). Subsite analysis demonstrated that the majority of tumors (64%) originated in the pyriform sinus. The 5-year survival for this subset of patients improved from 73% (1973-89) to 82% (1990-2003) ( P < .0002). Conclusion: In contrast to the decreased trends documented for laryngeal cancer, survival has improved in patients with squamous cell carcinoma of the hypopharynx over the past 2 decades. Primary therapy for these patients has largely been with radiation or radiation/surgery, with an increasing number of patients being treated with radiation alone.