TY - JOUR
T1 - Surgery vs. radiotherapy for locally advanced hypopharyngeal cancer in the contemporary era
T2 - A population-based study
AU - Kim, Yi Jun
AU - Lee, Rena
N1 - Funding Information:
This study was supported by 2017 Young Medical Science Researcher Grants from Ewha Womans University College of Medicine.
Publisher Copyright:
© 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
PY - 2018/12
Y1 - 2018/12
N2 - Objectives: To compare overall survival (OS) in locally advanced hypopharyngeal cancer treated with surgery or definitive chemoradiotherapy in the contemporary era. Methods: From 2010 to 2015, data for patients diagnosed with hypopharyngeal cancer (T2-T4aM0) and treated with total pharyngectomy with lymph node dissection (surgery group) or definitive radiotherapy and chemotherapy (chemoradiotherapy group) was retrieved from the SEER database. Multivariate analyses were performed in each subgroup divided according to T category (T2-3 or T4a). Results: The number of patients in the surgery and chemoradiotherapy groups was 209 and 648, respectively. Among them, the number of T4a patients was 111 and 126 in each group. Three-year OS rate in the surgery and chemoradiotherapy groups was 37.9% and 44.1%, respectively (P = 0.178). The 3-year OS rate for the T2-3 patients was 46.5% and 48.7% (P = 0.598), and the 3-year OS rate for the T4a patients was 29.9% and 26.1% in the surgery and chemoradiotherapy groups, respectively (P = 0.439). On multivariate analysis, the chemoradiotherapy group was not inferior to the surgery group in T2-T4a patients (Hazard ratio [HR] for the chemoradiotherapy group 0.889, 95% confidence interval [CI] 0.699-1.129, P = 0.334), in T2-3 patients (HR 0.932, 95% CI 0.699-1.297, P = 0.675), and in T4a patients (HR 0.880, 95% CI 0.617-1.256, P = 0.481). Conclusions: Chemoradiotherapy for locally advanced hypophagyngeal cancer showed a comparable OS rate to surgery. For patients with T4a category cancer with high possibility of preserving the laryngopharyngeal function, chemoradiotherapy may be a promising alternative treatment.
AB - Objectives: To compare overall survival (OS) in locally advanced hypopharyngeal cancer treated with surgery or definitive chemoradiotherapy in the contemporary era. Methods: From 2010 to 2015, data for patients diagnosed with hypopharyngeal cancer (T2-T4aM0) and treated with total pharyngectomy with lymph node dissection (surgery group) or definitive radiotherapy and chemotherapy (chemoradiotherapy group) was retrieved from the SEER database. Multivariate analyses were performed in each subgroup divided according to T category (T2-3 or T4a). Results: The number of patients in the surgery and chemoradiotherapy groups was 209 and 648, respectively. Among them, the number of T4a patients was 111 and 126 in each group. Three-year OS rate in the surgery and chemoradiotherapy groups was 37.9% and 44.1%, respectively (P = 0.178). The 3-year OS rate for the T2-3 patients was 46.5% and 48.7% (P = 0.598), and the 3-year OS rate for the T4a patients was 29.9% and 26.1% in the surgery and chemoradiotherapy groups, respectively (P = 0.439). On multivariate analysis, the chemoradiotherapy group was not inferior to the surgery group in T2-T4a patients (Hazard ratio [HR] for the chemoradiotherapy group 0.889, 95% confidence interval [CI] 0.699-1.129, P = 0.334), in T2-3 patients (HR 0.932, 95% CI 0.699-1.297, P = 0.675), and in T4a patients (HR 0.880, 95% CI 0.617-1.256, P = 0.481). Conclusions: Chemoradiotherapy for locally advanced hypophagyngeal cancer showed a comparable OS rate to surgery. For patients with T4a category cancer with high possibility of preserving the laryngopharyngeal function, chemoradiotherapy may be a promising alternative treatment.
KW - SEER
KW - chemoradiotherapy
KW - locally advanced hypopharyngeal cancer
KW - total pharyngectomy
UR - http://www.scopus.com/inward/record.url?scp=85057307404&partnerID=8YFLogxK
U2 - 10.1002/cam4.1811
DO - 10.1002/cam4.1811
M3 - Article
C2 - 30479063
AN - SCOPUS:85057307404
SN - 2045-7634
VL - 7
SP - 5889
EP - 5900
JO - Cancer Medicine
JF - Cancer Medicine
IS - 12
ER -