Survival benefit of surgical approach for advanced oropharyngeal and hypopharyngeal cancer: A retrospective analysis

Head Neck. 2017 Oct;39(10):2104-2113. doi: 10.1002/hed.24869. Epub 2017 Jul 10.

Abstract

Background: Head and neck cancer is increasingly being managed through nonsurgical approaches. Evidence comes from studies that have mainly examined patients with laryngeal cancer. Few studies, with limited sample size, have focused on the comparative outcomes of surgical and nonsurgical approaches in patients with advanced oropharyngeal or hypopharyngeal cancer.

Methods: Using a national cancer database, we identified 1603 and 1512 patients with clinical stage III/IVA oropharyngeal and hypopharyngeal cancer, respectively, treated between 2004 and 2009. The study cohort was followed until 2012, and analyzed through Kaplan-Meier survival analysis and Cox regression.

Results: Overall, 31.4% of patients with advanced oropharyngeal cancer and 42.2% of patients with hypopharyngeal cancer received surgery as their primary treatment. Receiving primary surgery for advanced oropharyngeal and hypopharyngeal cancer was associated with higher survival rates after controlling for potential confounders.

Conclusion: We recommend that surgery be considered a first-line treatment for advanced oropharyngeal and hypopharyngeal cancers.

Keywords: cancer; hypopharynx; oropharynx; surgery; survival.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Databases, Factual
  • Female
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Laryngectomy / methods*
  • Male
  • Middle Aged
  • Pharyngeal Neoplasms / mortality
  • Pharyngeal Neoplasms / surgery*
  • Pharyngectomy / methods*
  • Pharynx / pathology*
  • Pharynx / surgery
  • Proportional Hazards Models
  • Retrospective Studies
  • Survival Rate
  • Taiwan