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. 2017 Dec 29;17(1):904.
doi: 10.1186/s12885-017-3880-6.

Clinicopathological factors influencing the outcomes of surgical treatment in patients with T4a hypopharyngeal cancer

Sang-Yeon Kim  1 , Young-Soo Rho  2 , Eun-Chang Choi  3 , Min-Sik Kim  1 , Joo-Hyun Woo  4 , Dong Hoon Lee  5 , Eun Jae Chung  6 , Min Woo Park  2 , Da-Hee Kim  3 , Young-Hoon Joo  7   8
Affiliations

Clinicopathological factors influencing the outcomes of surgical treatment in patients with T4a hypopharyngeal cancer

Sang-Yeon Kim et al. BMC Cancer. .

Abstract

Background: The purpose of this study was to determine prognostic factors influencing outcomes of surgical treatment in patients with T4a hypopharyngeal cancer.

Methods: The present study enrolled 93 patients diagnosed with T4a hypopharyngeal cancer who underwent primary surgery between January 2005 and December 2015 at six medical centers in Korea. Primary tumor sites included pyriform sinus in 71 patients, posterior pharyngeal wall in 14 patients, and postcricoid region in 8 patients. Seventy-two patients received postoperative radio(chemo)therapy.

Results: Five-year disease-free survival (DFS) and disease-specific survival (DSS) rates were 38% and 45%, respectively. In univariate analysis, 5-year DFS was found to have significant and positive correlations with margin involvement (p < 0.001) and extracapsular spread (p = 0.025). Multivariate analysis confirmed that margin involvement (hazard ratio (HR): 2.81; 95% confidence interval (CI): 1.49-5.30; p = 0.001) and extracapsular spread (HR: 2.08; 95% CI: 1.08-3.99; p = 0.028) were significant factors associated with 5-year DFS. In univariate analysis, cervical lymph node metastasis (p = 0.048), lymphovascular invasion (p = 0.041), extracapsular spread (p = 0.015), and esophageal invasion (p = 0.033) were significant factors associated with 5-year DSS. In multivariate analysis, extracapsular spread (HR: 2.98; 95% CI: 1.39-6.42; p = 0.005) and esophageal invasion (HR: 2.87; 95% CI: 1.38-5.98; p = 0.005) remained significant factors associated with 5-year DSS.

Conclusion: Margin involvement and extracapsular spread are factors influencing recurrence while extracapsular spread and esophageal invasion are factors affecting survival in patients with T4a hypopharyngeal cancer treated by primary surgery.

Keywords: Head and neck neoplasms; Hypopharynx; Squamous cell carcinoma; Surgery; Treatment outcome.

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Conflict of interest statement

Ethics approval and consent to participate

Approval for this study was obtained from the Institutional Review Board of the Catholic University of Korea, Seoul, Korea. (IRB no. KC16RIMI0958; Seoul, Korea). Due to its retrospective nature without individually identifiable or sensitive information, the requirement for informed consent was waived.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Kaplan-Meier disease-free survival curves according to resection margin involvement (a) and extracapsular spread (b). Resection margin involvement (p < 0.001) and extracapsular spread (p = 0.025) showed significant associations with 5-year disease-free survival
Fig. 2
Fig. 2
Kaplan-Meier 5-year disease-specific survival curves according to extracapsular spread (a) and esophageal invasion (b). Extracapsular spread (p = 0.015) and esophageal invasion (p = 0.033) showed significant associations with 5-year disease-specific survival
See this image and copyright information in PMC

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