Treatment results for hypopharyngeal cancer by different treatment strategies and its secondary primary- an experience in Taiwan

Abstract

PurposeThe aim of this study was to evaluate treatment results in our hypopharyngeal cancer patients.Patients and MethodsA total of three hundred and ninety five hypopharyngeal cancer patients received radical treatment at our hospital; 96% were male. The majority were habitual smokers (88%), alcohol drinkers (73%) and/or betel quid chewers (51%). All patients received a CT scan or MRI for tumor staging before treatment. The stage distribution was stage I: 2 (0.5%); stage II: 22 (5.6%); stage III: 57 (14.4%) and stage IV: 314 (79.5%). Radical surgery was used first in 81 patients (20.5%), and the remaining patients (79.5%) received organ preservation-intended treatment (OPIT). In the OPIT group, 46 patients received radiotherapy alone, 156 patients received chemotherapy followed by radiotherapy (CT/RT) and 112 patients received concomitant chemo-radiotherapy (CCRT).ResultsThe five-year overall survival rates for stages I/II, III and IV were 49.5%, 47.4% and 18.6%, respectively. There was no significant difference in overall and disease-specific survival rates between patients who received radical surgery first and those who received OPIT. In the OPIT group, CCRT tended to preserve the larynx better (p = 0.088), with three-year larynx preservation rates of 44.8% for CCRT and 27.2% for CT/RT. Thirty-seven patients developed a second malignancy, with an annual incidence of 4.6%.ConclusionsThere was no survival difference between OPIT and radical surgery in hypopharyngeal cancer patients at our hospital. CCRT may offer better laryngeal preservation than RT alone or CT/RT. However, prospective studies are still needed to confirm this finding. Additionally, second primary cancers are another important issue for hypopharyngeal cancer management.

Dynamic Contrast-Enhanced MR Imaging Predicts Local Control in Oropharyngeal or Hypopharyngeal Squamous Cell Carcinoma Treated with Chemoradiotherapy

“…Our findings agree with previous studies that patients with hypopharyngeal SCC had a worse outcome than patients with oropharyngeal SCC [24,32,39,41]. In this study, the tumor location (oropharynx versus hypopharynx) was weakly associated with the 2-year local control rate and showed slightly significant difference between the control and failure group, in which oropharyngeal SCC had better chemoradiation response than hypopharyngeal SCC.…”

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

“…Furthermore, 20% of patients underwent TPL as the primary treatment, mainly because of thyroid or cricoid cartilage invasion. Similarly, Chang et al, in a study analyzing treatment results for hypopharyngeal cancer in Taiwan, showed that radical surgery was used first in 20.5% of patients [15]. The induction CT response rate of 80% in the present study was comparable to results reported in recent larynx preservation trials [5][6][7].…”

“…The oncologic outcomes reported in the present study were comparable to those published in other studies on locally advanced hypopharyngeal cancer [12,13,15]. Five-year OS rates ranging from 25 to 50% are usually published depending on the clinical characteristics of the patients and treatment modalities.…”

“…In an intensity-modulated RT with concurrent CT study on patients with locally advanced resectable hypopharyngeal cancer, Huang et al reported a 5-year functional larynx preservation survival of 40% [13]. In another study on patients with hypopharyngeal cancer, Chang et al showed that those treated by concurrent RT + CT had a larynx preservation rate of 44.8% at 3 years [15].…”

“…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]. Some recent larynx preservation trials reported better survival results but they included both laryngeal and hypopharyngeal cancers [5][6][7].…”