Matched-Pair Analysis of Survival in the Patients with Advanced Laryngeal and Hypopharyngeal Squamous Cell Carcinoma Treated with Induction Chemotherapy Plus Chemo-Radiation or Total Laryngectomy

Abstract

Background: We performed a comparative analysis between an organ-preservation protocol and surgery followed by radiotherapy in patients with locally advanced squamous cell carcinoma of the larynx and hypopharynx; Methods: 60 previously untreated patients who were treated with induction chemotherapy followed by chemoradiotherapy in responders were compared with a control group of 60 patients treated with up-front surgery. Both groups were statistically comparable, according to the subsite, TNM (tumor-node-metastasis) stage, age, and sex; Results: Mean age was 58 years and 92% were male. No significant statistical difference was observed for overall survival (OS) (HR 0.75; 95% CI 0.48–1,18; P = 0.22) and disease-specific survival (DSS) (HR 0.98; 95% CI 0.52–1.83, P = 0.96). Also, there was no significant difference for recurrence-free survival (HR 0.931; 95% CI 0.57–1.71; P = 0.81), metastases-free survival (HR 2.23; 95% CI 0.67–7.41; P = 0.19), and the appearance of second primary tumors (HR 1.22; 95% CI 0.51–2.88; P = 0.64); Conclusions: The results of the organ-preservation approach did not appear inferior to those of surgery plus (chemo)radiotherapy for patients with T3/T4a larynx and T2–T4a hypopharynx cancer with respect to OS and DSS, locoregional control and metastases-free survival.

Treatment and outcome among patients with laryngeal squamous cell carcinoma in Stockholm—A population‐based study

“…There are several studies that compare primary TL with different larynx preservation methods including CRT, but the results are inconclusive. 8 , 9 , 10 , 11 , 12 , 13 This indicates the need for further research especially regarding the management of advanced laryngeal cancer.…”

Construction and Validation of a UPR‐Associated Gene Prognostic Model for Head and Neck Squamous Cell Carcinoma

“…HNSCC is divided into oral squamous cell carcinoma (OSCC), oropharyngeal carcinoma, nasopharyngeal carcinoma, laryngeal carcinoma, etc. The pathogenic factors of these cancers are diverse, and survival outcomes differ in the different subsites of HNSCC [ 39 ]. Therefore, HNSCC information in TCGA database is relatively mixed.…”

Matched-pair analysis of survival in patients with poorly differentiated versus well and moderately differentiated hypopharyngeal squamous cell carcinoma

“…All pathological diagnoses were confirmed by 2 pathologists. The pairing criteria were as follows: (1) age difference within 5 years; (2) same sex (male or female); (3) same smoking status (non-smoker or smoker); (4) same alcohol use (non-drinker or drinker); (5) same primary tumor site (pyriform sinus, postcricoid region or posterior wall of the hypopharynx); (6) comorbidity score (none to mild or moderate to severe); (7) same TNM stage; and (8) same therapeutic strategies (primary surgery and primary (chemo)radiation).…”

“…features, lifestyle factors, fundamental role of mitochondria on survival and response to treatment, and epidemiologic variables, and these prognostic factors may further confound survival analysis. [7][8][9][10][11][12] Matched-pair analysis allows for the removal of such confounding factors and a more accurate comparison of survival.…”