Surgery vs. radiotherapy for locally advanced hypopharyngeal cancer in the contemporary era: A population‐based study

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.

Treatment sequence and survival in locoregionally advanced hypopharyngeal cancer: A surveillance, epidemiology, and end results–based study

“…11,12 Conversely, other studies have suggested better survival for those treated with surgery compared to RT alone. [12][13][14] Chemotherapy data were not available within the SEER registry previous to the SEER 18 release, and no prior SEER study has clearly examined the sequence of radiation therapy and surgery. Most studies combine primary surgery groups with those that received salvage surgery.…”

Management of Advanced-stage Hypopharyngeal Carcinoma: 25-Year Experience from a Tertiary Care Medical Center

“…[13][14][15]17,23]. SEER (Surveillance, Epidemiology and, End Results) database analysis did not find a difference in three-year survival for T4 patients between surgical and non-surgical treatments (29.9% vs. 26.1%, p = 0.439) [24]. A single-institution experience from Taiwan reported equivalent survival among patients who received laryngeal preservation or operative management [25].…”

A 25-year Experience at an Academic Medical Center in the United States: Are There Racial Disparities in the Prognosis of Patients Diagnosed With Hypopharyngeal Carcinoma?

“…Even though advanced treatment options exist, the prognosis for advanced stage hypopharyngeal cancer is poor [14]. As multispecialty decision-making is required for optimal treatment selection, various factors are considered during a patient's evaluation [14].…”

“…Even though advanced treatment options exist, the prognosis for advanced stage hypopharyngeal cancer is poor [14]. As multispecialty decision-making is required for optimal treatment selection, various factors are considered during a patient's evaluation [14]. These include survival estimates, treatment benefits, adverse effects from treatment, patient expectations, and the patient's quality of life [14][15].…”

“…As multispecialty decision-making is required for optimal treatment selection, various factors are considered during a patient's evaluation [14]. These include survival estimates, treatment benefits, adverse effects from treatment, patient expectations, and the patient's quality of life [14][15]. There are minimal reports on racial disparities in the treatment of hypopharyngeal cancer among AA and CA patients.…”