Management of advanced hypopharyngeal carcinoma: systematic review of survival following surgical and non-surgical treatments

Abstract

Background: Advanced hypopharyngeal carcinoma has a dismal prognosis. The optimal treatment for these patients remains under debate. This systematic review aimed to compare survival following surgical and non-surgical treatments.

Methods: A systematic review was conducted of randomised studies, with a descriptive analysis of retrospective observational studies.

Results: Two randomised trials and 11 observational studies were included in the review. A meta-analysis of randomised trials reported a hazard ratio of 0.89 for overall survival in favour of surgical treatment (p = 0.44). Neither treatment was favoured in terms of overall survival. Observational studies did not report a survival advantage with either treatment. The five-year larynx preservation rates for non-surgically treated patients were between 38 and 58 percent.

Conclusion: Chemoradiotherapy offers similar survivorship compared to surgery in advanced disease, while also making larynx preservation feasible. It can be used as a treatment in all patients as an alternative to surgery.

Keywords: Operative; Carcinoma; Concurrent Chemoradiotherapy; Hypopharynx; Larynx; Organ Preservation; Surgical Procedures; Survival.