Treatment results and prognostic factors in locally advanced hypopharyngeal cancer

Lee, Moon‐Sing; Ho, Han‐Chen; Hsiao, Shih-Hsuan; Hwang, Juen-Haur; Lee, Ching‐Chih; Hung, Shih‐Kai

doi:10.1080/00016480701387116

Cited by 31 publications

(26 citation statements)

References 18 publications

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“…For local-regionally advanced hypopharyngeal tumors, 3y-DM free survival rates of as low as 30% are reported [8,17]. Comparisons of DM rates between the studies are difficult due to a wide range of treatment approaches, staging examinations, and treatments.…”

Section: Discussionmentioning

confidence: 99%

Prediction of Distant Metastasis in Head Neck Cancer Patients: Implications for Induction Chemotherapy and Pre-treatment Staging?

2008

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Background and Purpose: Intensity modulated radiation therapy (IMRT) combined treatment approaches, surgical and radiodiagnostic advances, respectively, lead to improved local-regional control in head neck cancer (HNC). With increasing local-regional control, distant metastases (DM) become more meaningful. In some trials without concomitant chemotherapy, induction chemotherapy (IC) resulted in an absolute reduction of DM by ~10-15%. In order to define a more efficient selection of patients at risk for DM with respect to IC and M-staging, we analysed our patients treated by contemporary standards. Patients and Methods: Between 1/2002 to 12/2007, 409 HNC patients were treated with IMRT; 303/409 (74%) underwent definitive, 106 (26%) postoperative IMRT. The mean/median follow-up was 23/20 months (3-72). 70% tolerated 4-7, 9% 1-3 cycles of simultaneous cisplatin. Treatment followed a prospectively designed protocol. In a previous study with 172 HNC IMRT patients, gross tumor volume (GTV) was found the strongest predictor for local-regional control. In the current study, this criterion has been prospectively tested for DM. Numbers needed to treat were calculated for IC. Results: DM developed in 28/399 (7%) patients; 10 presented initially with DM (total 38/409). In 13/28 (46%), DM remained the only manifestation of disease. GTV was the strongest predictor for DM (p < 0.0001) of all tested. Only 4% of patients with GTV < 70 cc developed DM, vs. 25% (18/73) with > 70 cc; only 6 of them (6/73, 8%) developed isolated DM. Conclusion: GTV was the most significant predictor for DM, that could guide selective pre-treatment M-staging. The subgroup with isolated DM in the high risk group, that could benefit from IC, is small. (Table 1). Die Therapie folgte einem prospektiv festgelegten Protokoll. In einer früheren Studie mit 172 KHTPatienten mit definitiver IMRT wurde das "gross tumor volume" (GTV) als signifikantester Prädiktor für die Lokoregionalkontrolle nachgewiesen. In der hier präsentierten Studie wurde dasselbe volumetrische Staging-System getestet hinsichtlich dessen prä-diktiven Wert für DM, um eine allfällige IC wie auch die initiale Metastasensuche selektiver auf ein Hochrisikopatientensegment beschränken zu können. Ergebnisse: DM fanden sich bei 38/409 Patienten bzw. bei 28/399 mit initialem M0-Status (7%) (Abbildung 1, Tabelle 2); 10 Patienten hatten initial bereits DM. Bei nur 13/28 (46%) blieben DM die einzige Krankheitsmanifestation. Das GTV erwies sich als signifikantester aller getesteter Metastasenprädiktoren (p < 0,0001, Abbildung 2, Tabelle 3); nur 4% der Patienten mit einem GTV < 70 cc entwickelten DM, vs. 25% (18/73) mit GTV > 70 cc, von diesen nur 6 mit isolierter DM (6/73, 8%). IntroductionClinical implementation of intensity modulated radiation therapy (IMRT), together with combined treatment approaches in definitive and postoperative treatment settings, surgical and radio-diagnostic advances, respectively, lead to an encouraging improvement of the loco-regional control in head and neck cancer (HNC)...

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Section: Discussionmentioning

confidence: 99%

Prediction of Distant Metastasis in Head Neck Cancer Patients: Implications for Induction Chemotherapy and Pre-treatment Staging?

2008

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“…More than three-quarters of patients afflicted with this cancer are at an advanced stage at the time of diagnosis (1). In the course of the disease, because of the early high rates of cervical lymph nodes metastasis (2), the overall survival is relatively poor, with 5-year survival rates <40%, despite aggressive surgical and adjuvant treatment (3,4). Smoking cigarettes and drinking alcohol are the main risk factors for HSCC (5).…”

Section: Introductionmentioning

confidence: 99%

Stathmin1 overexpression in hypopharyngeal squamous cell carcinoma: A new promoter in FaDu cell proliferation and migration

Chen

Zhang

Ding

et al. 2016

International Journal of Oncology

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Stathmin1, a microtubule-destabilizing phosphoprotein, is considered to play a crucial role in regulating cellular microtubule dynamics and controlling mitosis. Previous studies have showed that STMN1 is highly expressed in many human malignancies and is related to development, invasion and metastasis of tumors. However, its expression pattern, clinical performance and functional roles in hypopharyngeal squamous cell carcinoma (HSCC) have not been addressed. In this study, we found that STMN1 was significantly elevated in HSCC and its expression level was correlated with poor differentiation (P<0.001), clinical stage (P<0.001), large tumor size (P=0.001) and lymph node metastasis (P=0.008). A positive correlation between STMN1 and Ki-67 expression was also exhibited. High STMN1 expression predicted poor survival. Furthermore, we found that knockdown of STMN1 by siRNAs inhibited the FaDu cell proliferation and migration. Moreover, decreased STMN1 expression in FaDu cells reversed the acquisition of EMT phenotype by upregulating E-cadherin, as well as reduced vimentin expression at protein and mRNA levels. These results suggested that STMN1 plays an important role in proliferation and migration of HSCC and may be used as a potential prognostic biomarker or therapeutic target of HSCC.

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“…Five-year OS rates ranging from 25 to 50% are usually published depending on the clinical characteristics of the patients and treatment modalities. Lee et al reported a 3-year OS rate of 39% in patients treated with concurrent RT + CT [16]. In patients treated by primary radical surgery or by larynx preservation-intended treatment, Chang et al showed 5-year OS rates of 47.4% and 18.6% for patients with stage III and IV hypopharynx cancer, respectively, without any significant difference according to the modality of treatment [15].…”

Section: Discussionmentioning

confidence: 95%

Contemporary therapeutic management of locally advanced hypopharyngeal cancer: oncologic and functional outcomes – a report on 100 cases

Vandersteen

Bénézery²,

Chamorey³

et al. 2015

Acta Oto-Laryngologica

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A total of 100 patients were included in this study. Induction chemotherapy (CT) followed by radiotherapy (RT) ± CT, primary RT + CT, and primary total pharyngolaryngectomy (TPL) comprised the initial therapeutic management for 54, 24, and 20 patients, respectively. Two patients received only supportive care. Overall survival (OS) and cause-specific survival (SS) were 50% and 60% at 3 years, respectively. In the group of patients referred for induction CT, the 3-year OS and SS were 58% and 70%, respectively. In multivariate analysis, T stage (p = 0.05) and ASA score (p = 0.02) were significant predictive factors of OS. T4 tumor stage had a pejorative impact on swallowing function after therapy (p = 0.006). The rate of patients alive, disease-free, and with a functional larynx at 2 years was 23%.

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Treatment results and prognostic factors in locally advanced hypopharyngeal cancer

Cited by 31 publications

References 18 publications

Prediction of Distant Metastasis in Head Neck Cancer Patients: Implications for Induction Chemotherapy and Pre-treatment Staging?

Prediction of Distant Metastasis in Head Neck Cancer Patients: Implications for Induction Chemotherapy and Pre-treatment Staging?

Stathmin1 overexpression in hypopharyngeal squamous cell carcinoma: A new promoter in FaDu cell proliferation and migration

Contemporary therapeutic management of locally advanced hypopharyngeal cancer: oncologic and functional outcomes – a report on 100 cases

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