Survival Outcomes of the Patients With Advanced Hypopharyngeal Squamous Cell Carcinoma Treated With Chemoradiotherapy and Total Pharyngolaryngectomy Based on Reports of Head and Neck Cancer Registry of Japan.

Abstract

For laryngeal preservation in locally advanced hypopharyngeal cancer (HPC), the role of induction chemotherapy (ICT) and chemoradiotherapy (CRT) as alternatives to total pharyngolaryngectomy (TPL) remains unclear. We analyzed 825 patients with T3N0-2M0 and 900 with T4aN0-2M0 HPC from the Head and Neck Cancer Registry of Japan (2011-2015). Oncological outcomes of ICT, CRT, and TPL were evaluated. Propensity score matching analysis (PSM) was performed between TPL and CRT, excluding ICT. In T4aN0-2M0 patients, ICT followed by TPL significantly improved overall survival and local recurrence-free survival (LRFS) compared with TPL, and ICT followed by CRT significantly improved LRFS compared with CRT. No significant differences in survival were observed between TPL and CRT in both T3N0-2M0 and T4aN0-2M0 patients in PSM. ICT benefited T4aN0-2M0 patients. CRT did not compromise survival compared with TPL in T3-4aN0-2M0 patients, supporting the rationale of ICT and CRT for advanced HPC.