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Clinicopathological factors influencing the outcomes of surgical treatment in patients with T4a hypopharyngeal cancer

 Sang-Yeon Kim  ;  Young-Soo Rho  ;  Eun-Chang Choi  ;  Min-Sik Kim  ;  Joo-Hyun Woo  ;  Dong Hoon Lee  ;  Eun Jae Chung  ;  Min Woo Park  ;  Da-Hee Kim  ;  Young-Hoon Joo 
 BMC CANCER, Vol.17(1) : 904, 2017-12 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell / mortality* ; Carcinoma, Squamous Cell / secondary* ; Carcinoma, Squamous Cell / surgery ; Female ; Follow-Up Studies ; Humans ; Hypopharyngeal Neoplasms / mortality* ; Hypopharyngeal Neoplasms / pathology* ; Hypopharyngeal Neoplasms / surgery ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck Dissection / mortality* ; Neoplasm Invasiveness ; Prognosis ; Retrospective Studies ; Survival Rate
Head and neck neoplasms ; Hypopharynx ; Squamous cell carcinoma ; Surgery ; Treatment outcome.
Background: The purpose of this study was to determine prognostic factors influencing outcomes of surgical treatment in patients with T4a hypopharyngeal cancer.

Methods: The present study enrolled 93 patients diagnosed with T4a hypopharyngeal cancer who underwent primary surgery between January 2005 and December 2015 at six medical centers in Korea. Primary tumor sites included pyriform sinus in 71 patients, posterior pharyngeal wall in 14 patients, and postcricoid region in 8 patients. Seventy-two patients received postoperative radio(chemo)therapy.

Results: Five-year disease-free survival (DFS) and disease-specific survival (DSS) rates were 38% and 45%, respectively. In univariate analysis, 5-year DFS was found to have significant and positive correlations with margin involvement (p < 0.001) and extracapsular spread (p = 0.025). Multivariate analysis confirmed that margin involvement (hazard ratio (HR): 2.81; 95% confidence interval (CI): 1.49-5.30; p = 0.001) and extracapsular spread (HR: 2.08; 95% CI: 1.08-3.99; p = 0.028) were significant factors associated with 5-year DFS. In univariate analysis, cervical lymph node metastasis (p = 0.048), lymphovascular invasion (p = 0.041), extracapsular spread (p = 0.015), and esophageal invasion (p = 0.033) were significant factors associated with 5-year DSS. In multivariate analysis, extracapsular spread (HR: 2.98; 95% CI: 1.39-6.42; p = 0.005) and esophageal invasion (HR: 2.87; 95% CI: 1.38-5.98; p = 0.005) remained significant factors associated with 5-year DSS.

Conclusion: Margin involvement and extracapsular spread are factors influencing recurrence while extracapsular spread and esophageal invasion are factors affecting survival in patients with T4a hypopharyngeal cancer treated by primary surgery.
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1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Da Hee(김다희) ORCID logo https://orcid.org/0000-0001-7286-1334
Choi, Eun Chang(최은창)
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