Radiotherapy or surgery for head and neck squamous cell cancer: establishing the baseline for hypopharyngeal carcinoma?

Abstract

The authors compared the survival outcomes of radiotherapy+/-salvage surgery to surgery+/-postoperative radiotherapy for patients with squamous cell cancer of the hypopharynx. There was no evidence beyond observational studies and no consensus on the which treatment is most effective for this patient group. The authors conducted a retrospective population-based study of 595 patients from Ontario Canada diagnosed between January 1, 1990 and December 31, 1999. Three different methodological approaches were used for the survival analysis including a restricted cohort study, a matched case-control study, and a natural experiment study across defined geographic regions. The authors found no survival advantage for either radiotherapy+/-salvage surgery or surgery+/-postoperative radiotherapy. This study set the baseline for clinical decisions that was not previously established there is no difference in survival for patients with hypopharynx comparing primary surgery to primary radiotherapy. This information is essential for the interpretation of current treatment results, the planning of future clinical studies and the treatment of patients who are not having chemoradiotherapy.