The impact of surgical margin status on the outcomes of locally advanced hypopharyngeal squamous cell carcinoma treated by primary surgery

Abstract

Background: The extent of surgical safety margin remained unclear in hypopharyngeal carcinoma surgery.Aim: The purpose of this study was to evaluate the influence of surgical margin status on the outcomes of patients with advanced hypopharyngeal carcinoma.Material and methods: A retrospective analysis of clinical data was performed in 205 patients with stage III/IV hypopharyngeal carcinoma treated by primary surgery between January 2005 and December 2014. There were 129 patients with clear surgical margins (≥5 mm) and 76 with close surgical margins (<5 mm). The clinical characteristics and treatment outcomes were compared between the two groups.Results: Close surgical margin (cSM) was found to be a significant risk factor for local recurrence, overall survival (OS) and disease-specific survival (DSS). Analysis by stratification according to pT classification showed that the OS and DSS rates of T1/T2 tumors with clear surgical margins (nSM) were significantly higher than those with cSM (p < .05), while there was no significant difference in the OS and DSS rates between T3/T4 tumors with cSM and nSM (p > .05).Conclusions and significance: The tailored extent of surgical resection margin was recommended for locally advanced hypopharyngeal carcinomas according to primary tumor stage.