Evolving treatment and survival in hypopharyngeal cancer: A single-center study.

Abstract

Background: Patients with hypopharyngeal squamous cell carcinoma (HPSCC) often present with advanced disease, resulting in poor prognoses. Traditional treatment involves radical surgery, which affects the quality of life considerably. At present, treatment is shifting away from primary surgical therapy. However, the long-term adverse effect is notable. This study examined the treatment outcomes of patients with HPSCC at a single medical center to assess the effects of evolving treatment modalities on survival and laryngeal preservation.

Methods: This retrospective study analyzed patients with HPSCC treated from 2004 to 2012. To assess the effects of changes in treatment modalities, the study period was divided into three blocks: 2004-2006, 2007-2009, and 2010-2012. Tumor recurrence, functional laryngeal outcomes, and survival rates were assessed across the three periods.

Results: A total of 167 patients with HPSCC (161 males and seven females; median age: 57 years) were analyzed. The proportion of patients undergoing surgery, specifically transoral laser microsurgery (TLM), increased over time. The laryngeal preservation rates increased from 14% to 41%, and the tumor recurrence rates reduced from 48% to 31% over the study period. Surgery-based treatment was associated with survival rates comparable to those of chemoradiotherapy, with 5-year overall survival and disease-specific survival rates increasing over time from 32% to 55% and from 37% to 73%, respectively.

Conclusion: Advancements in surgical techniques, precise radiotherapy, chemotherapy regimens, and refined treatment protocols have significantly enhanced survival outcomes and laryngeal preservation rates for patients with HPSCC over time. TLM has emerged as an effective conservation surgery in patients with early-stage and select cases of advanced HPSCC, offering the benefit of preserving laryngeal function.