Abstract
ObjectivesTo compare overall survival (OS) in locally advanced hypopharyngeal cancer treated with surgery or definitive chemoradiotherapy in the contemporary era.MethodsFrom 2010 to 2015, data for patients diagnosed with hypopharyngeal cancer (T2‐T4aM0) and treated with total pharyngectomy with lymph node dissection (surgery group) or definitive radiotherapy and chemotherapy (chemoradiotherapy group) was retrieved from the SEER database. Multivariate analyses were performed in each subgroup divided according to T category (T2‐3 or T4a).ResultsThe number of patients in the surgery and chemoradiotherapy groups was 209 and 648, respectively. Among them, the number of T4a patients was 111 and 126 in each group. Three‐year OS rate in the surgery and chemoradiotherapy groups was 37.9% and 44.1%, respectively (P = 0.178). The 3‐year OS rate for the T2‐3 patients was 46.5% and 48.7% (P = 0.598), and the 3‐year OS rate for the T4a patients was 29.9% and 26.1% in the surgery and chemoradiotherapy groups, respectively (P = 0.439). On multivariate analysis, the chemoradiotherapy group was not inferior to the surgery group in T2‐T4a patients (Hazard ratio [HR] for the chemoradiotherapy group 0.889, 95% confidence interval [CI] 0.699‐1.129, P = 0.334), in T2‐3 patients (HR 0.932, 95% CI 0.699‐1.297, P = 0.675), and in T4a patients (HR 0.880, 95% CI 0.617‐1.256, P = 0.481).ConclusionsChemoradiotherapy for locally advanced hypophagyngeal cancer showed a comparable OS rate to surgery. For patients with T4a category cancer with high possibility of preserving the laryngopharyngeal function, chemoradiotherapy may be a promising alternative treatment.
Highlights
Hypopharyngeal cancer is a poor prognostic cancer.[1]
For T4a hypopharyngeal cancer,radiotherapy showed a poor survival rate compared to the radical surgery,[2,5,6] and the invasion of thyroid or cricoid cartilage were considered as to be difficult to preserve laryngopharyngeal function after chemoradiotherapy.[7]
Three‐year overall survival (OS) rates of the surgery and chemoradiotherapy groups were calculated by the Kaplan‐Meier survival estimate
Summary
Hypopharyngeal cancer is a poor prognostic cancer.[1]. The 5‐year overall survival (OS) rate is approximately 35%.2 the survival rate has been significantly improved,[3] the absolute survival rate has been strikingly restricted for decades compared to human papilloma virus‐related oropharyngeal cancer.[4]Optimal treatment for locally advanced hypopharyngeal cancer is controversial, especially in T4a cancer. Hypopharyngeal cancer is a poor prognostic cancer.[1] The 5‐year overall survival (OS) rate is approximately 35%.2. The survival rate has been significantly improved,[3] the absolute survival rate has been strikingly restricted for decades compared to human papilloma virus‐related oropharyngeal cancer.[4]. Optimal treatment for locally advanced hypopharyngeal cancer is controversial, especially in T4a cancer. For T4a hypopharyngeal cancer, (chemo)radiotherapy showed a poor survival rate compared to the radical surgery,[2,5,6] and the invasion of thyroid or cricoid cartilage were considered as to be difficult to preserve laryngopharyngeal function after chemoradiotherapy.[7] surgery is considered as the treatment of choice for T4a cancer. According to the National Comprehensive Cancer Network Categories of Evidence and KIM and LEE
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