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Matched-pair analysis of patients with advanced hypopharyngeal cancer: surgery versus concomitant chemoradiotherapy

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Abstract

Background

The aim of this study was to compare the therapeutic outcomes of total pharyngolaryngectomy with those of concomitant chemoradiotherapy in advanced hypopharyngeal cancer.

Methods

This is a retrospective multi-institutional study. The medical records of 979 patients with hypopharyngeal cancer, who were initially treated between 2006 and 2008, were reviewed. In this study, we matched a group of total pharyngolaryngectomy patients with a second group of chemoradiotherapy patients, according to age, gender, subsite, arytenoid fixation, cartilage invasion, and N classification, and analyzed overall survival, disease-specific survival, and locoregional control rates.

Results

The matched-pair analysis included 254 patients. The 5-year overall survival, disease-specific survival, and locoregional control rates were 58.5% and 53.5% (P = 0.30), 68.9% and 68.0% (P = 0.80), and 82.2% and 63.6% (P < 0.01), respectively, for patients in the total pharyngolaryngectomy and chemoradiotherapy groups. For T4a patients with cartilage invasion, the matched-pair analysis included 46 patients. The 5-year overall survival, disease-specific, and locoregional control rates were 56.5% and 26.0% (P = 0.092), 56.5% and 41.3% (P = 0.629), and 43.0% and 42.5% (P = 0.779), respectively, for patients in the total pharyngolaryngectomy and chemoradiotherapy groups.

Conclusions

The data from this large-scale multi-institutional joint research program of hypopharyngeal cancer in Japan suggest that chemoradiotherapy may provide adequate survival benefit for hypopharyngeal cancer patients with the distinct advantage of larynx preservation. Our data also suggest that chemoradiotherapy is as beneficial as total pharyngolaryngectomy for the local control of locally advanced hypopharyngeal cancer.

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Acknowledgments

This research was supported by a Health and Labour Sciences Research Grant (H22-Clinical Cancer Research-general-017) from the Japanese Ministry of Health, Labour, and Welfare.

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Authors and Affiliations

  1. Department of Head and Neck Surgery, Hyogo Cancer Center, 13-70 Kitaoji, Akashi, Hyogo, 673-8558, Japan

    Shigemichi Iwae, Hidetoshi Matsui & Koichiro Yonezawa

  2. Department of Otolaryngology, Eiju General Hospital, Tokyo, Japan

    Masato Fujii

  3. Division of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan

    Ryuichi Hayashi

  4. Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan

    Yasuhisa Hasegawa

  5. Department of Head and Neck Surgery, Osaka International Cancer Institute, Osaka, Japan

    Takashi Fujii

  6. Department of Otolaryngology, Tokai University, Isehara, Kanagawa, Japan

    Kenji Okami

  7. Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan

    Akihiro Homma

  8. Department of Head and Neck Surgery, Shizuoka Cancer Center, Nagaizumi, Shizuoka, Japan

    Tetsuro Onitsuka

  9. Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan

    Takakuni Kato

  10. Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan

    Takenori Ogawa

  11. Department of Otolaryngology, Kindai University Faculty of Medicine, Osakasayama, Osaka, Japan

    Kyoichi Terao

  12. Department of Head and Neck surgery, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime, Japan

    Nobuya Monden

  13. Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan

    Naoki Otsuki & Ken-ichi Nibu

  14. Department of Otolaryngology and Head and Neck Surgery, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan

    Hiroshi Nishino

  15. Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara, Nara, Japan

    Ichiro Ota

  16. Department of Otolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Yasushi Fujimoto

  17. Division of Head and Neck Surgery, Miyagi Cancer Center, Natori, Miyagi, Japan

    Kazuto Matsuura

  18. Department of Head and Neck Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan

    Kazuyoshi Kawabata

Authors
  1. Shigemichi Iwae
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  2. Masato Fujii
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  3. Ryuichi Hayashi
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  4. Yasuhisa Hasegawa
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  5. Takashi Fujii
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  6. Kenji Okami
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  7. Akihiro Homma
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  8. Tetsuro Onitsuka
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  9. Takakuni Kato
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  10. Takenori Ogawa
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  11. Kyoichi Terao
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  12. Nobuya Monden
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  13. Naoki Otsuki
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  14. Hiroshi Nishino
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  15. Ichiro Ota
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  16. Yasushi Fujimoto
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  17. Kazuto Matsuura
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  18. Kazuyoshi Kawabata
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  19. Hidetoshi Matsui
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  20. Koichiro Yonezawa
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  21. Ken-ichi Nibu
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Corresponding author

Correspondence to Shigemichi Iwae.

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The authors declare no conflicts of interest.

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Iwae, S., Fujii, M., Hayashi, R. et al. Matched-pair analysis of patients with advanced hypopharyngeal cancer: surgery versus concomitant chemoradiotherapy. Int J Clin Oncol 22, 1001–1008 (2017). https://doi.org/10.1007/s10147-017-1151-9

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  • DOI: https://doi.org/10.1007/s10147-017-1151-9

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