Up‐front neck dissection followed by chemoradiotherapy for <scp>T1–T3</scp> hypopharyngeal cancer with advanced nodal involvement

Satõ, Mitsuo; Otsuki, Naoki; Kitano, Mitsuhide; Ishikawa, Kazuki; Tanaka, Kaoru; Kimura, Takayuki; Doi, Kunio

doi:10.1002/hed.26881

Cited by 9 publications

(3 citation statements)

References 27 publications

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“…Carsuzaa et al [19] reported that upfront ND signi cantly improved locoregional control and Boros et al [17] reported that upfront ND could be associated with improved outcomes in non-oropharyngeal N3 HNSCC. In this study, DFS in the CRT group was slightly worse than that reported [12,17], and the results declined rapidly over two years. It is possible that our study only included N3 hypopharyngeal carcinoma, especially the large amount of unresectable N3.…”

Section: Discussioncontrasting

confidence: 49%

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Upfront neck dissection versus concurrent chemoradiotherapy in stage T1–3N3 hypopharyngeal carcinoma: A comparative study of clinical outcomes and predictive factors

Sakai

Ebisumoto

Iijima

et al. 2023

Preprint

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Purpose This study assessed the efficacy of upfront neck dissection (ND) versus concurrent chemoradiotherapy (CRT) in patients diagnosed with T1–3N3 hypopharyngeal carcinoma (HPC).Methods This retrospective study enrolled patients with T1–3N3 HPC who had undergone upfront ND followed by CRT (upfront group) or only CRT (CRT group). Local control rate, neck control rate, metastasis-free rate, disease-free survival, disease-specific survival, and overall survival were compared between the upfront and CRT groups. Univariate and multivariate analyses using Cox proportional hazards models were performed to identify the survival-related clinical and systemic factors.Results Forty-eight patients were enrolled in this study, with 18 in upfront group and 30 in CRT group. The groups differed significantly in terms of neck control rate (p = 0.000121) and disease-free survival (p = 0.0256). The upfront CRT group showed a significantly better overall survival (OS) than that of the unresectable CRT group (p = 0.046). Among the various factors, node status, body mass index, and platelet-to-lymphocyte ratio were significantly associated with OS in a univariate analysis.Conclusion Upfront ND can be recommended for T1–3N3 HPC, provided resectability is feasible.

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Section: Discussioncontrasting

confidence: 49%

“…Distant metastases and locoregional failure remain critical treatment challenges [9]. To address these challenges, various approaches to improve the outcome of treating HPC have been explored [5,7,[10][11][12]. A key factor in this is an improved control of the cervical lymph nodes.…”

Section: Introductionmentioning

confidence: 99%

Upfront neck dissection versus concurrent chemoradiotherapy in stage T1–3N3 hypopharyngeal carcinoma: A comparative study of clinical outcomes and predictive factors

Sakai

Ebisumoto

Iijima

et al. 2023

Preprint

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“…Recently, Sato et al 12 conducted a study to investigate the impact of UFND followed by CCRT on oncologic outcomes in patients with hypopharyngeal cancer with advanced neck involvement. The results of this study showed that the treatment modality could provide satisfactory regional control, but had no impact on DSS and OS.…”

Section: Discussionmentioning

confidence: 99%

Enhancing regional control in p16-negative oropharyngeal cancer: A propensity score-matched analysis of upfront neck dissection and definitive chemoradiotherapy

Lee,

Fang,

Lee

et al. 2024

Journal of the Chinese Medical Association

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Background: The presence of p16 and neck disease are important predictors of prognosis for oropharyngeal squamous cell carcinoma (OPSCC). Patients who are p16-negative and have clinically node-positive (cN+) disease generally have worse oncologic outcomes. This study aimed to investigate whether upfront neck dissection (UFND) could provide potential benefits for patients with cN+ p16-negative OPSCC. Methods: Through this retrospectively study, 76 patients with cN+ p16-negative OPSCC were analyzed, those who received either definite concurrent chemoradiotherapy (CCRT group) or UFND followed by chemoradiotherapy (UFND group). The primary endpoints were regional recurrence-free survival (RRFS), disease-specific survival (DSS), and overall survival (OS). Factors associated with survival were evaluated by univariate and multivariate analysis. Survival between the two groups was compared by propensity score-matched analysis. Results: Matched 23 patients in each group through propensity analysis, the UFND group showed a significantly better 5-year RRFS (94.1% vs. 61.0%, p=0.011) compared to the CCRT group. Univariate analysis revealed that UFND was the sole factor associated with regional control (HR=0.110; 95% CI, 0.014-0.879; p=0.037). Furthermore, the study found that the CCRT group was associated with a higher dose of radiotherapy and exhibited a significantly higher risk of mortality due to pneumonia. Conclusion: The study indicated that UFND followed by CCRT may be a potential treatment option for patients with cN+ p16-negative OPSCC, as it can reduce the risk of regional recurrence. Additionally, the study highlights that definite CCRT is connected to a larger dose of radiotherapy and a higher risk of fatal pneumonia. These findings could be beneficial in informing clinical decision-making and improving treatment outcomes for patients with OPSCC.

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Up‐front neck dissection followed by chemoradiotherapy for T1–T3 hypopharyngeal cancer with advanced nodal involvement

et al. 2021

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Background: The advantage of up-front neck dissection (UFND) followed by chemoradiotherapy (CRT) for hypopharyngeal cancer (HPC) with advanced neck involvement remains controversial. We aimed to determine the indications.Methods: The data of 41 and 14 patients with stage IVA/B (T1-T3 and ≥N2a) HPC who underwent UFND followed by CRT and received CRT, respectively, were retrospectively analyzed and compared. Results: The 5-year overall survival (OS) and disease-specific survival rates for the UFND and CRT groups were 61% and 52% (p = 0.1019), and 89% and 74% (p = 0.2333), respectively. Moreover, patients aged ≥70 years or those with a pulmonary disease history had a significantly poorer prognosis due to aspiration pneumonia in the UFND group. The 5-year regional control (RC) for the UFND and CRT groups were 92% and 57%, respectively (p = 0.0001).Conclusions: UFND followed by CRT was feasible with satisfactory RC. To further improve OS, aspiration pneumonia prevention is essential.

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Up‐front neck dissection followed by chemoradiotherapy for T1–T3 hypopharyngeal cancer with advanced nodal involvement

Cited by 9 publications

References 27 publications

Upfront neck dissection versus concurrent chemoradiotherapy in stage T1–3N3 hypopharyngeal carcinoma: A comparative study of clinical outcomes and predictive factors

Upfront neck dissection versus concurrent chemoradiotherapy in stage T1–3N3 hypopharyngeal carcinoma: A comparative study of clinical outcomes and predictive factors

Enhancing regional control in p16-negative oropharyngeal cancer: A propensity score-matched analysis of upfront neck dissection and definitive chemoradiotherapy

Up‐front neck dissection followed by chemoradiotherapy for T1–T3 hypopharyngeal cancer with advanced nodal involvement

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