Prognostic effects of different treatment modalities for hypopharyngeal squamous cell carcinoma: Experience of two tertiary hospitals in Southwestern China
Junhong Li,
Shanshan He,
Jifeng Liu,
Di Deng,
Yijun Dong,
Wendu Pang,
Mao Minzi,
Ke Qiu,
Jing Zeng,
Yao Song,
Yufang Rao,
Yu Zhao,
Xinyin Xu,
Shichuan Zhang,
Ren Jianjun
Affiliations
Junhong Li
Department of Otolaryngology-Head & Neck Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
Shanshan He
Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Sichuan Cancer Center, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, China; Sichuan Provincial People's Hospital Jinniu Hospital, China
Jifeng Liu
Department of Otolaryngology-Head & Neck Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
Di Deng
Department of Otolaryngology-Head & Neck Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
Yijun Dong
Department of Otolaryngology-Head & Neck Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
Wendu Pang
Department of Otolaryngology-Head & Neck Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
Mao Minzi
Department of Otolaryngology-Head & Neck Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
Ke Qiu
Department of Otolaryngology-Head & Neck Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
Jing Zeng
Sichuan Center for Disease Control and Prevention, Chengdu, China; Corresponding author. Jing ZENG.
Yao Song
Department of Otolaryngology-Head & Neck Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
Yufang Rao
Department of Otolaryngology-Head & Neck Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
Yu Zhao
Department of Otolaryngology-Head & Neck Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
Xinyin Xu
Sichuan Center for Disease Control and Prevention, Chengdu, China; Corresponding authors.
Shichuan Zhang
Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Sichuan Cancer Center, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, China; Corresponding author.
Ren Jianjun
Department of Otolaryngology-Head & Neck Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China; Corresponding authors. No.37 Guoxue Alley, Wuhou District, Chengdu, Sichuan Province, China.
Background: The prognostic effects of different treatment modalities on patients with hypopharyngeal squamous cell carcinoma (HPSCC) remain unclear. Methods: HPSCC patients diagnosed and treated at either West China Hospital or Sichuan Cancer Hospital between January 1, 2009, and December 31, 2019, were enrolled in this retrospective, real-world study. Survival rates were presented using Kaplan–Meier curves and compared using log-rank tests. Univariable and multivariable Cox proportional hazards regression models were used to identify the predictors of overall survival (OS). Subgroup analyses were conducted for patients with advanced-stage HPSCC (stages III and IV and category T4). Results: A total of 527 patients with HPSCC were included. Patients receiving SRC (surgery, radiotherapy [RT], and chemotherapy) showed the best OS (p < 0.0001). In comparison with RT alone, both surgery alone (all cases: hazard ratio [HR] = 0.39, p = 0.0018; stage IV cases: HR = 0.38, p = 0.0085) and surgery-based multimodality treatment (SBMT; all cases: HR = 0.27, p < 0.0001; stage IV cases: HR = 0.30, p = 0.00025) showed prognostic benefits, while SBMT also showed survival priority over chemoradiotherapy (CRT; all cases: HR = 0.52, p < 0.0001; stage IV cases: HR = 0.59, p = 0.0033). Moreover, patients who underwent surgery alone had comparable OS to those who underwent SBMT (all patients: p = 0.13; stage IV cases: p = 0.34), while CRT yielded similar prognostic outcomes as RT alone (all patients: p = 0.054; stage IV cases: p = 0.11). Conclusions: Surgery alone was comparable to SBMT and superior to RT/CRT in terms of OS in patients with HPSCC. We suggest that surgery should be encouraged for the treatment of HPSCC, even in patients with advanced-stage disease.
