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

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Abstract

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.

Original languageEnglish
Article number904
JournalBMC Cancer
Volume17
Issue number1
DOIs
StatePublished - 29 Dec 2017

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Hypopharyngeal Neoplasms
Confidence Intervals
Disease-Free Survival
Survival
Multivariate Analysis
Pyriform Sinus
Korea
Radio
Survival Rate
Lymph Nodes
Neoplasm Metastasis
Recurrence

Keywords

  • Head and neck neoplasms
  • Hypopharynx
  • Squamous cell carcinoma
  • Surgery
  • Treatment outcome

Cite this

Kim, S. Y., Rho, Y. S., Choi, E. C., Kim, M. S., Woo, J. H., Lee, D. H., ... Joo, Y. H. (2017). Clinicopathological factors influencing the outcomes of surgical treatment in patients with T4a hypopharyngeal cancer. BMC Cancer, 17(1), [904]. https://doi.org/10.1186/s12885-017-3880-6
Kim, Sang Yeon ; Rho, Young Soo ; Choi, Eun Chang ; Kim, Min Sik ; Woo, Joo Hyun ; Lee, Dong Hoon ; Chung, Eun Jae ; Park, Min Woo ; Kim, Da Hee ; Joo, Young Hoon. / Clinicopathological factors influencing the outcomes of surgical treatment in patients with T4a hypopharyngeal cancer. In: BMC Cancer. 2017 ; Vol. 17, No. 1.
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abstract = "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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Clinicopathological factors influencing the outcomes of surgical treatment in patients with T4a hypopharyngeal cancer. / Kim, Sang Yeon; Rho, Young Soo; Choi, Eun Chang; Kim, Min Sik; Woo, Joo Hyun; Lee, Dong Hoon; Chung, Eun Jae; Park, Min Woo; Kim, Da Hee; Joo, Young Hoon.

In: BMC Cancer, Vol. 17, No. 1, 904, 29.12.2017.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinicopathological factors influencing the outcomes of surgical treatment in patients with T4a hypopharyngeal cancer

AU - Kim, Sang Yeon

AU - Rho, Young Soo

AU - Choi, Eun Chang

AU - Kim, Min Sik

AU - Woo, Joo Hyun

AU - Lee, Dong Hoon

AU - Chung, Eun Jae

AU - Park, Min Woo

AU - Kim, Da Hee

AU - Joo, Young Hoon

PY - 2017/12/29

Y1 - 2017/12/29

N2 - 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.

AB - 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.

KW - Head and neck neoplasms

KW - Hypopharynx

KW - Squamous cell carcinoma

KW - Surgery

KW - Treatment outcome

UR - http://www.scopus.com/inward/record.url?scp=85039697147&partnerID=8YFLogxK

U2 - 10.1186/s12885-017-3880-6

DO - 10.1186/s12885-017-3880-6

M3 - Article

C2 - 29284434

AN - SCOPUS:85039697147

VL - 17

JO - BMC cancer

JF - BMC cancer

SN - 1471-2407

IS - 1

M1 - 904

ER -