Survival benefit of surgical approach for advanced oropharyngeal and hypopharyngeal cancer: A retrospective analysis

Cheng, Chih‐Tao; Lin, Ching-Yuan; Cheng, Skye Hung-Chun; Lin, Yu Shia; Lim, Lay-Chin; Pennarun, Nicolas; Liu, Zhen-Ying; Terng, Shyuang‐Der

doi:10.1002/hed.24869

Cited by 10 publications

(8 citation statements)

References 40 publications

(73 reference statements)

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“… 2 However, recent evidence confirms that patients who undergo primary surgery have better survival outcomes than those treated with non-surgical strategies, which indicates that surgery remains the primary option for this disease. 13 – 16 Because of the rich lymphatic network in the neck and the submucosal invasive behavior of tumor cells, the recurrence rates for patients with HSCC who are treated with surgery are relatively high. 5 Thus, POAT including RT, chemotherapy, and immunotherapy could also be useful to eliminate residual cancer cells and reduce disease recurrence.…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a nomogram to predict cancer-specific survival in patients with hypopharyngeal squamous cell carcinoma treated with primary surgery

Wang

Xiao

et al. 2021

J Int Med Res

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Objective We aimed to develop a nomogram to predict cancer-specific survival (CSS) in patients with hypopharyngeal squamous cell carcinoma (HSCC) treated with primary surgery to provide more accurate risk stratification for patients. Methods We retrospectively collected data of 1144 eligible patients with HSCC from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015. Patients were randomly divided into training and validation groups (ratio 6:4) and we used univariate and multivariate Cox analysis. We developed and validated a nomogram using calibration plots and time-dependent receiver operating characteristic, Kaplan–Meier, and decision curves. Results Age; marital status; T, N, and M stage; and postoperative adjuvant therapy were independent factors associated with CSS, which were included in the nomogram. The nomogram’s C-index was 0.705 to 0.723 in the training group and 0.681 to 0.736 in the validation group, which were significantly higher than conventional American Joint Committee on Cancer (AJCC) staging. Calibration curves showed good agreement between prediction and observation in both groups. Kaplan–Meier and decision curves suggested the nomogram had better risk stratification and net benefit than conventional AJCC staging. Conclusions We established a nomogram that was superior to conventional AJCC staging in predicting CSS for HSCC.

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Section: Discussionmentioning

confidence: 99%

Development and validation of a nomogram to predict cancer-specific survival in patients with hypopharyngeal squamous cell carcinoma treated with primary surgery

Wang

Xiao

et al. 2021

J Int Med Res

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“…Several studies insisted that (chemo)radiotherapy for T4a hypopharyngeal cancer showed a poor survival rate compared to surgery . On the other hand, a multi‐institutional study which performed a matched‐pair analysis between surgery and chemoradiotherapy between 2006 and 2008 showed no significant differences in survival or local control rates between the two treatment groups even in T4a category patients …”

Section: Discussionmentioning

confidence: 99%

“…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, and the invasion of thyroid or cricoid cartilage were considered as to be difficult to preserve laryngopharyngeal function after chemoradiotherapy . Therefore, surgery is considered as the treatment of choice for T4a cancer.…”

Section: Introductionmentioning

confidence: 99%

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

Kim

Lee

2018

Cancer Medicine

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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.

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“…In the Western countries, clinicians tend to choose less expensive conservative treatment (radiotherapy and chemotherapy) due to its low incidence [ 1 ], while in China, HSCC patients typically receive comprehensive treatment with surgery [ 2 ]. A variety of surgical skills and principles have been developed, resulting in significant improvement for laryngeal function and swallowing function [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Discovery and Validation of a CT-Based Radiomic Signature for Preoperative Prediction of Early Recurrence in Hypopharyngeal Carcinoma

Wei

Wushouer

et al. 2020

BioMed Research International

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Purpose. In the clinical management of hypopharyngeal squamous cell carcinoma (HSCC), preoperative identification of early recurrence (≤2 years) after curative resection is essential. Thus, we aimed to develop a CT-based radiomic signature to predict early recurrence in HSCC patients preoperatively. Methods. In total, 167 HSCC patients who underwent partial surgery were enrolled in this retrospective study and divided into two groups, i.e., the training cohort (n=133) and the validation cohort (n=34). Each individual was followed up for at least for 2 years. Radiomic features were extracted from CT images, and the radiomic signature was built with the least absolute shrinkage and selection operator (LASSO) logistic regression (LR) model. The associations of preoperative clinical factors with early recurrence were evaluated. A radiomic signature-combined model was built, and the area under the curve (AUC) was used to explore their performance in discriminating early recurrence. Results. Among the 1415 features, 335 of them were selected using the variance threshold method. Then, the SelectKBest method was further used for the selection of 31 candidate features. Finally, 11 out of 31 optimal features were identified with the LASSO algorithm. In the LR classifier, the AUCs of the training and validation sets in discriminating early recurrence were 0.83 (95% CI: 0.76-0.90) (sensitivity 0.8 and specificity 0.83) and 0.83 (95% CI: 0.67-0.99) (sensitivity 0.69 and specificity 0.71), respectively. Conclusions. Using the radiomic signature, we developed a radiomic signature to preoperatively predict early recurrence in patients with HSCC, which may serve as a potential noninvasive tool to guide personalized treatment.

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Survival benefit of surgical approach for advanced oropharyngeal and hypopharyngeal cancer: A retrospective analysis

Abstract: We recommend that surgery be considered a first-line treatment for advanced oropharyngeal and hypopharyngeal cancers.

Cited by 10 publications

References 40 publications

Development and validation of a nomogram to predict cancer-specific survival in patients with hypopharyngeal squamous cell carcinoma treated with primary surgery

Development and validation of a nomogram to predict cancer-specific survival in patients with hypopharyngeal squamous cell carcinoma treated with primary surgery

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

Discovery and Validation of a CT-Based Radiomic Signature for Preoperative Prediction of Early Recurrence in Hypopharyngeal Carcinoma

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