Survival analyses of different treatment modalities and clinical stage for hypopharyngeal carcinoma

Tian-Yun Lin; Tsung-Lun Lee; Yen-Bin Hsu; Shyh-Kuan Tai; Ling-Wei Wang; Muh-Hwa Yang; Pen-Yuan Chu

doi:10.3389/fonc.2023.1109417

Survival analyses of different treatment modalities and clinical stage for hypopharyngeal carcinoma

Front Oncol. 2023 Mar 3:13:1109417. doi: 10.3389/fonc.2023.1109417. eCollection 2023.

Authors

Tian-Yun Lin¹, Tsung-Lun Lee^{2

3}, Yen-Bin Hsu^{2

3}, Shyh-Kuan Tai^{2

3}, Ling-Wei Wang^{3

4}, Muh-Hwa Yang^{3

5

6}, Pen-Yuan Chu^{2

3}

Affiliations

¹ Department of Otolaryngology-Head and Neck Surgery, Taichung Veterans General Hospital, Taichung, Taiwan.
² Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.
³ Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
⁴ Division of Radiation Oncology, Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan.
⁵ Division of Medical Oncology, Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan.
⁶ Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.

Abstract

Objective: We investigated the effects of different treatment modalities and clinical stage for hypopharyngeal carcinoma (HPC) patients.

Methods: Between February 2004 and December 2012, 167 HPC patients were reviewed. We calculated overall survival (OS), progression-free survival (PFS), local failure-free survival (LFFS), regional failure-free survival (RFFS), and distant metastasis failure-free survival (DMFFS) using the Kaplan-Meier method and compared various survival outcomes between definitive chemoradiotherapy (CRT) and surgery-based therapy (SBT).

Results: There were no significant differences in baseline characteristics between SBT (n = 102) and definitive CRT (n = 65) groups. The 5-year rates of OS (59.7% vs. 24.0%, p < 0.0001) and PFS (49.9% vs. 22.6%, p = 0.0002) were significantly better in patients who received SBT than in those who received definitive CRT. The SBT group also obtained better LFFS (p < 0.0001), RFFS (p = 0.0479), and DMFFS (p = 0.0110). We did similar analyses by different T-classification (T1-2, T3, and T4) and found that SBT had better OS (p < 0.0001 and p = 0.0020), PFS (p < 0.0001 and p = 0.0513), LFFS (p = 0.0002 and p = 0.0075), RFFS (p = 0.1949 and p = 0.0826), and DMFFS (p = 0.0248 and p = 0.0436) in the T4 and T1-2 subgroups but similar OS (p = 0.9598), PFS (p = 0.5052), RFFS (p = 0.9648), and DMFFS (p = 0.8239) in T3 patients. Analyses by different overall stages revealed no differences between definitive CRT and SBT for stage III patients but significantly better results for stage IV patients who received SBT.

Conclusions: SBT can obtain significant survival benefits when compared with definitive CRT for the whole cohort of patients. Definitive CRT has similar survival outcomes compared with SBT only for T3 tumors or overall stage III disease.

Keywords: chemoradiotherapy; clinical stage; hypopharyngeal carcinoma; surgery-based therapy; survival.

Grants and funding

This study was supported by grants from the Taipei Veterans General Hospital (V110C-113), the research program of the Ministry of Science and Technology (109-2314-B-075-013-MY3), and kind financial support from Dr. Morris Chang and Sophie Chang, who had no involvement or conflict of interests in this study. Besides, the authors thank the Taichung Veterans General Hospital for supporting open access and the article processing fee.