Trends in treatment, incidence and survival of hypopharynx cancer: a 20-year population-based study in the Netherlands

Abstract

Hypopharynx cancer has the worst prognosis of all head and neck squamous cell cancers. Since the 1990s, a treatment shift has appeared from a total laryngectomy towards organ preservation therapies. Large randomized trials evaluating treatment strategies for hypopharynx cancer, however, remain scarce, and frequently this malignancy is evaluated together with larynx cancer. Therefore, our aim was to determine trends in incidence, treatment and survival of hypopharynx cancer. We performed a population-based cohort study including all patients diagnosed with T1–T4 hypopharynx cancer between 1991 and 2010 in the Netherlands. Patients were recorded by the national cancer registry database and verified by a national pathology database. 2999 patients were identified. The incidence increased significantly with 4.1% per year until 1997 and decreased non-significantly afterwards. For women, the incidence increased with 1.7% per year during the entire study period. Total laryngectomy as primary treatment significantly decreased, whereas radiotherapy and chemoradiation increased. The 5-year overall survival significantly increased from 28% in 1991–2000 to 34% in 2001–2010. Overall survival for T3 was equal for total laryngectomy and (chemo)radiotherapy, but for T4-patients the survival was significantly better after primary total laryngectomy (± adjuvant radiotherapy). This large population-based study demonstrates a shift in treatment preference towards organ preservation therapies. The 5-year overall survival increased significantly in the second decade. The assumed equivalence of organ preservation and laryngectomy may require reconsideration for T4 disease.Electronic supplementary materialThe online version of this article (doi:10.1007/s00405-017-4766-6) contains supplementary material, which is available to authorized users.

Effect of up‐regulation of circMATR3 on the proliferation, metastasis, progression and survival of hypopharyngeal carcinoma

“…Hypopharyngeal squamous cell carcinoma (HSCC) is an aggressive tumour arising from the outer layer (epithelium) of the upper aerodigestive tract and accounts for 5%‐15% of all head and neck squamous cell carcinoma (HNSCC) . Due to the recent improvements in modern comprehensive treatment strategies including surgery, chemotherapy and radiotherapy, the 5‐year survival rate for patients with early‐stage HSCC is as high as 70%; however, the majority of HSCCs are diagnosed at an advanced stage (stage III or IV), with a 5‐year survival rate of about 35%, and HSCC patients are also vulnerable to relapse. Therefore, it is critical to identify new prognostic biomarkers and therapeutic targets facilitating the early diagnosis of HSCCs and improving the clinical outcomes of patients.…”

Clinical and functional outcomes after total laryngectomy and laryngopharyngectomy: Analysis by tumor subsite, salvage status, and extent of resection

“…Advanced (stage III/IV) laryngeal and hypopharyngeal squamous cell carcinomas (SCCs) have an estimated 5‐year overall survival (5y OS) of approximately 50% and 35%, respectively. With increasing use of organ preservation therapy (OPT) over the past several decades, surgical intervention has traditionally been reserved for patients with extra‐laryngeal extension, compromised laryngeal function and/or those developing disease recurrence.…”

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

“…Hypopharyngeal cancer is a poor prognostic cancer . The 5‐year overall survival (OS) rate is approximately 35% . Although the survival rate has been significantly improved, the absolute survival rate has been strikingly restricted for decades compared to human papilloma virus‐related oropharyngeal cancer …”

“…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.…”