The Prognostic Importance of Radiologic Extranodal Extension in Hypopharyngeal Carcinoma.

IF 2.3 3区医学 Q1 OTORHINOLARYNGOLOGY

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2024-11-04 DOI:10.1002/hed.27978

Yu-Hao Liao, Ya-Fang Chen, Min-Shu Hsieh, Mei-Chun Lin, Chun-Wei Wang, Cheng-Ping Wang, Pei-Jen Lou, Tseng-Cheng Chen

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Abstract

Background: Extranodal extension (ENE) had been included in the latest cancer staging system in hypopharyngeal squamous cell carcinoma (HypoSCC). However, the impact of ENE on HypoSCC survival and treatment outcomes are still unclear.

Methods: Records from all HypoSCC patients diagnosed at the National Taiwan University Hospital from January 2007 to December 2018 were reviewed. All patients were divided into two groups, with or without ENE. Clinical features, pathological factors, and survival rates between the two groups were reviewed.

Results: We analyzed data from 388 HypoSCC patients, 125 (32.22%) with and 263 (67.78%) without ENE. The 5-year overall survival of the HypoSCC patients with radiological ENE, pathological ENE, and without ENE were 22.9%, 40.3%, and 55.5%. From the multivariate analysis, primary T3/T4 classification (p = 0.001) and radiological ENE (p < 0.001) were independent risk factors for disease-free and overall survival (OS). Finally, upfront neck dissection may significantly benefit disease-free survival (DFS) and neck nodal control in ENE+ (p = 0.002 and p = 0.007, respectively) or ENE- patients (p = 0.003 and p = 0.02, respectively).

Conclusion: More than one-third of HypoSCC patients have ENE, with significantly lower OS and DFS. The upfront neck dissection could provide better DFS and neck nodal control.

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下咽癌放射学结节外扩展的预后意义

背景：结节外扩展（ENE）已被纳入下咽鳞状细胞癌（HypoSCC）的最新癌症分期系统。然而，ENE对下咽鳞状细胞癌生存率和治疗效果的影响仍不明确：回顾了 2007 年 1 月至 2018 年 12 月期间在台湾大学医院确诊的所有下咽鳞状细胞癌患者的记录。将所有患者分为有 ENE 或无 ENE 两组，回顾两组患者的临床特征、病理因素和存活率：我们分析了388例HypoSCC患者的数据，其中125例（32.22%）有ENE，263例（67.78%）无ENE。有放射学ENE、病理学ENE和无ENE的HypoSCC患者的5年总生存率分别为22.9%、40.3%和55.5%。多变量分析结果显示，原发性 T3/T4 分级（P = 0.001）和放射学 ENE（P 结论：原发性 T3/T4 分级和放射学 ENE 的患者 5 年总生存率分别为 22.9%、40.3% 和 55.5%：超过三分之一的 HypoSCC 患者有 ENE，其 OS 和 DFS 明显较低。前期颈部切除可提供更好的 DFS 和颈部结节控制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.