A Survival Analysis of Hypopharyngeal Cancer Patients: A Hospital-Cancer registry Based Study


To study the survival in patients affected with hypopharyngeal cancer among treatment groups and different stages. Data of hypopharyngeal cancer patients diagnosed from 1st January 2010 to 31st December 2010 was used in the present study. The cases were analyzed for gender, age group distribution, sub-sites at presentation, stage at diagnosis and the type of treatments. Survival from the date of first diagnosis was estimated and hazard ratios were calculated. Survival probability and hazards ratios (HR) were calculated by Kaplan–Meier method and Cox-proportional regression analysis respectively. Censoring of patient who survived longer than 5 years was done. Active follow-up was done for the survival analysis. The study cohort included 217 patients and treatment compliance was observed in 46.9% of cases. The median age at diagnosis was 57 years (range 24–90), 86.2% of cases were locally advanced cases (stage III and IV), pyriform sinus was major sub-site (96%), radiotherapy was main treatment modality alone in 84.8% of cases, median survival was 31 months and 5-year overall survival was 36.9%, and HR for stage IV was 1.9 (P = 0.03, 95% CI − 1.04 to 3.7). In developing setting of North East India, radiotherapy was the main modality of treatment for hypopharyngeal cancer patients, and understanding the clinical parameters and survival of this group of cancers is crucial for its control.

This is a preview of subscription content, log in to check access.

Fig. 1
Fig. 2
Fig. 3


  1. 1.

    Consolidated Report of Population Based Cancer Registries 2009–2011. National Cancer Registry Programme-Indian Council of Medical Research; Bangalore, 2013

  2. 2.

    Kuo P, Chen MM, Decker RH, Yarbrough WG, Judson BL (2014) Hypopharyngeal cancer incidence, treatment, and survival: temporal trends in the United States. Laryngoscope 124:2064–2069

    Article  Google Scholar 

  3. 3.

    Sharma JD, Krishnatreya M, Das AK, Bhatacharyya M, Hazarika M, Kataki AC et al (2015) Radiotherapy and concurrent chemo-radiotherapy in locally advanced hypopharyngeal cancers—a hospital registry based analysis. Asian Pac J Cancer Prev 16:4723–4726

    Article  Google Scholar 

  4. 4.

    Lian X, Ji W (2015) Clinical characteristics of 97 hypopharyngeal carcinoma cases. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 29:542–546

    PubMed  Google Scholar 

  5. 5.

    Gupta T, Chopra S, Agarwal JP, Laskar SG, D’cruz AK, Shrivastava SK et al (2009) Squamous cell carcinoma of the hypopharynx: single-institution outcome analysis of a large cohort of patients treated with primary non-surgical approaches. Acta Oncol 48:541–548

    Article  Google Scholar 

  6. 6.

    Windfuhr JP, Andrae M, Chen YS, Makoski HB, Schröder M, Sesterhenn K (2008) Results after intensified therapy for advanced carcinoma of the hypopharynx. Ear Nose Throat J 87:E11

    PubMed  Google Scholar 

  7. 7.

    Iseli TA, Agar NJ, Dunemann C, Layons BM (2007) Functional outcomes following total laryngopharyngectomy. ANZ J Surg 77:954–957

    Article  Google Scholar 

  8. 8.

    Milisavljevic D, Stankovic M, Zivic M, Popovic M, Radovanović Z (2009) Factors affecting results of treatment of hypopharyngeal carcinoma. Hippokratia 13:154–160

    CAS  PubMed  PubMed Central  Google Scholar 

  9. 9.

    Newman JR, Connolly TM, Illing EA, Kilgore ML, Locher JL, Carroll WR (2015) Survival trends in hypopharyngeal cancer: a population-based review. Laryngoscope 125:624–629

    Article  Google Scholar 

  10. 10.

    Chavez-MacGregor M, Giordano SH (2016) Randomized clinical trials and observational studies: Is there a battle? J Clin Oncol 34:772–773

    CAS  Article  Google Scholar 

  11. 11.

    Kim JW, Kim MS, Kim SH, Kim JH, Lee CG, Kim GE et al (2016) Definitive chemoradiotherapy versus surgery followed by adjuvant radiotherapy in resectable stage III/IV hypopharyngeal cancer. Cancer Res Treat 48:45–53

    CAS  Article  Google Scholar 

  12. 12.

    Varghese BT, Babu S, Desai KP, Bava AS, George P, Iype EM et al (2014) Prospective study of outcomes of surgically treated larynx and hypopharyngeal cancers. Indian J Cancer 51:104–108

    CAS  Article  Google Scholar 

  13. 13.

    Sakashita T, Homma A, Hatakeyama H, Furusawa J, Kano S, Mizumachi T et al (2015) Clinical outcomes of weekly cisplatin chemoradiotherapy for patients with pyriform sinus cancer. Int J Clin Oncol 20:1081–1085

    CAS  Article  Google Scholar 

  14. 14.

    Goswami J, Mallik S, Adhikary A, Das S, Pal B (2015) Living with the Elekta Compact: limitations and ways around them. J Can Res Ther 11:479–481

    CAS  Article  Google Scholar 

  15. 15.

    Modesto A, Laprie A, Vieillevigne L, Graff P, Sarini J, Vergezet S et al (2015) Intensity-modulated radiotherapy for laryngeal and hypopharyngeal cancer: minimization of late dysphagia without jeopardizing tumor control. Strahlenther Onkol 191:225–233

    Article  Google Scholar 

  16. 16.

    Zhang X, Wang J, Wu W et al (2014) Efficacy and safety of combined radiotherapy with EGFR inhibitors and chemotherapy for laryngeal organ preservation in patients with locally advanced hypopharyngeal carcinomas. Curr Cancer Drug Targets 14:589–598

    CAS  Article  Google Scholar 

  17. 17.

    Inohara H, Takenaka Y, Yoshii T, Nakahara S, Yamamoto Y, Tomiyama Y et al (2015) Phase 2 study of docetaxel, cisplatin, and concurrent radiation for technically resectable stage III–IV squamous cell carcinoma of the head and neck. Int J Radiat Oncol Biol Phys 91:934–941

    CAS  Article  Google Scholar 

  18. 18.

    Zhao XG, Sun RJ, Yang XY, Liu DY, Lei DP, Jin T et al (2015) Chloroquine-enhanced efficacy of cisplatin in the treatment of hypopharyngeal carcinoma in xenograft mice. PLoS ONE 10:e0126147

    Article  Google Scholar 

  19. 19.

    Hall SF, Groome PA, Irish J, O’Sullivan B (2008) The natural history of patients with squamous cell carcinoma of the hypopharynx. Laryngoscope 118:1362–1371

    Article  Google Scholar 

  20. 20.

    Takes RP, Strojan P, Silver CE, Bradley PJ, Haigentz M Jr, Wolf GT et al (2012) Current trends in initial management of hypopharyngeal cancer: the declining use of open surgery. Head Neck 34:270–281

    Article  Google Scholar 

  21. 21.

    Jang JY, Kim EH, Cho J, Jung JH, Oh D, Ahn YC et al (2016) Comparison of oncological and functional outcomes between initial surgical versus non-surgical treatments for hypopharyngeal cancer. Ann Surg Oncol 23:2054–2061

    Article  Google Scholar 

  22. 22.

    Wycliffe ND, Grover RS, Kim PD, Simental A Jr (2007) Hypopharyngeal cancer. Top Magn Reson Imaging 18:243–258

    Article  Google Scholar 

  23. 23.

    Hua Y, Hu Q, Tang Q, Piao Y, Fu Z (2014) Prognostic significance of the number of positive lymph nodes, number of involved regions and metastatic lymph node ratio in hypopharyngeal cancer. Zhonghua Zhong Liu Za Zhi 36:783–787

    PubMed  Google Scholar 

  24. 24.

    Chen LY, Huang CC, Tsou YA, Bau DT, Tsai MH (2015) Prognostic factor of severe complications in patients with hypopharyngeal cancer with primary concurrent chemoradiotherapy. Anticancer Res 35:1735–1741

    PubMed  Google Scholar 

  25. 25.

    Nandakumar A, Rath GK, Kataki AC, Bapsy PP, Gupta PC, Gangadharan P et al (2016) Survival in head and neck cancers- results of a multi-institution study. Asian Pac J Cancer Prev 17:1745–1754

    Article  Google Scholar 

  26. 26.

    Lacas B, Bourhis J, Overgaard J, Zhang Q, Grégoire V, Nankivell M et al (2017) Role of radiotherapy fractionation in head and neck cancers (MARCH): an updated meta-analysis. Lancet Oncol 18:1221–1237

    Article  Google Scholar 

  27. 27.

    Woody NM, Ward MC, Koyfman SA, Reddy CA, Geiger J, Joshi N et al (2017) Adjuvant chemoradiation after surgical resection in elderly patients with high-risk squamous cell carcinoma of the head and neck: a National Cancer database analysis. Int J Radiat Oncol Biol Phys 98:784–792

    Article  Google Scholar 

  28. 28.

    Lee A, Givi B, Roden DF, Tam MM, Wu SP, Gerber NK et al (2017) Utilization and survival of postoperative radiation or chemoradiation for pT1-2N1M0 head and neck cancer. Otolaryngol Head Neck Surg 194599817746391. https://doi.org/10.1177/0194599817746391. [Epub ahead of print]

    Article  Google Scholar 

  29. 29.

    Petersen JF, Timmermans AJ, van Dijk BAC, Overbeek LIH, Smit LA, Hilgers FJM et al (2018) Trends in treatment, incidence and survival of hypopharynx cancer: a 20-year population-based study in the Netherlands. Eur Arch Otorhinolaryngol 275:181–189

    Article  Google Scholar 

  30. 30.

    Harris BN, Biron VL, Donald P, Farwell DG, Luu QC, Bewley AF et al (2015) Primary surgery vs chemoradiation treatment of advanced-stage hypopharyngeal squamous cell carcinoma. JAMA Otolaryngol Head Neck Surg 141:636–640

    Article  Google Scholar 

Download references


The authors would like to thank the National Centre for Disease Informatics and Research under Indian Council of Medical Research for providing the necessary technical support to our hospital cancer registry.

Author information



Corresponding author

Correspondence to Manigreeva Krishnatreya.

Ethics declarations

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical Approval

This article does not contain any studies with human participants performed by any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Krishnatreya, M., Kataki, A.C., Sharma, J.D. et al. A Survival Analysis of Hypopharyngeal Cancer Patients: A Hospital-Cancer registry Based Study. Indian J Otolaryngol Head Neck Surg 71, 798–804 (2019). https://doi.org/10.1007/s12070-018-1556-4

Download citation


  • Chemotherapy
  • Hypopharynx
  • Radiotherapy
  • Survival