Yu-Jie Shen, Tian Wang, Chang-Ding He, Hong-Li Gong, Cheng-Zhi Xu, Huai-Dong Du, Lei Tao, Ming Zhang, Liang Zhou
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引用次数: 0
Abstract
Objectives: cN3 larynx and hypopharynx cancer is rare with a poor prognosis. This study evaluates treatment approaches, effectiveness, and prognosis for these patients in real-world settings. It aims to offer targeted and practical clinical guidance to enhance their treatment results and quality of life.
Methods: This retrospective cohort study (2014-2021) included 192 cN3 larynx and hypopharynx cancer patients from Eye & ENT Hospital of Fudan University. We collected detailed information on demographics, tumor characteristics, and treatment outcomes. The study focused on overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS), using Kaplan-Meier and Cox regression analyses for independent prognostic analysis.
Results: This study encompassed 192 cN3 larynx and hypopharynx cancer patients, revealing a five-year overall survival rate of 40.60%. Treatment modalities analyzed included Surgery + CRT, ICT + Surgery + CRT, ICT + CRT, Surgery alone, and CRT alone. Patients receiving surgery followed by CRT demonstrated the most favorable prognosis (p < 0.0001) and the longest DFS (p < 0.0001), while those undergoing monotherapy had the poorest outcomes. Induction chemotherapy (ICT) achieved a 70% primary tumor response rate and a 48% neck lesion response rate, with patients showing a response to ICT exhibiting superior OS, CSS, and distant metastasis rate (DMR) (p < 0.05). Pathological type and primary tumor surgery were identified as independent prognostic factors for cN3 larynx and hypopharynx cancer.
Conclusion: This study shows that combined treatments, especially surgery followed by chemoradiotherapy, improve survival and prognosis for cN3 larynx and hypopharynx cancer patients. It highlights the importance of tailored treatments and notes better outcomes for those responding to ICT.
期刊介绍：
The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope.
• Broncho-esophagology
• Communicative disorders
• Head and neck surgery
• Plastic and reconstructive facial surgery
• Oncology
• Speech and hearing defects
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