Outcomes of Salvage Surgery after Concurrent Chemoradiation for Advanced Hypopharyngeal Cancer

Abstract

Background and ObjectivesZZWe evaluated treatment outcomes of patients with advanced hypopharyngeal cancer for whom surgical salvage was attempted after primary concomitant chemoradiation therapy (CRT) had failed as a treatment. The pre-salvage factors were assessed to predict the prognosis of salvage surgery. Subjects and MethodZZA retrospective analysis was conducted from 1997 to 2006 for 22 patients with stage III-IV hypopharyngeal cancer who had undergone salvage surgery after local and/or regional CRT failures with no distant metastasis. ResultsZZLarynx-sacrificing pharyngectomy was performed in 12 (54.5%) of all patients. Postoperative complications occurred in 9 (40.9%), and carotid artery blowout occurred in two of these patients. After salvage surgery, the 2-year and 5-year overall survival rates were 52.8% and 28.9%, respectively. The 2-year disease specific survival rate and locoregional con trol rate were 45.5% and 60.0%, respectively. The initial N2-3 stage (p=0.038) and the concurrent local and regional failures (p=0.035) were independent predictors for decreased survival after salvage surgery. Two-year overall survival rates for patients with 2, 1, or none of these predictive factors were 23.3%, 66.7%, and 80.0%, respectively (p=0.027). ConclusionZZAlthough salvage surgery after CRT has postoperative complications and unfavorable larynx preservation, it can be considered as a viable option with acceptable oncologic outcomes for advanced hypopharyngeal cancer. The initial N2-3 stage and concurrent local and regional failures were independent predictors that can stratify patients into distinct prognostic groups for postsalvage survival. � Korean J Otorhinolaryngol-Head Neck Surg 2011;54:703-10