Posttreatment Non-Improved Vocal Cord Mobility Indicates the Need of Salvage Surgery for Hypopharyngeal Carcinomas

• Published in: Frontiers in oncology Vol. 10; p. 600599
• Main Authors: He, Yu-qin, Zhang, Xi-wei, Zhu, Yi-ming, Ni, Xiao-guang, Huang, Ze-hao, An, Chang-ming, Yi, Jun-lin, Liu, Shao-yan
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 08.01.2021
• Subjects: hypopharyngeal neoplasms; Oncology; prognosis; radiotherapy; salvage therapy; vocal fold paralysis; radiotherapy; vocal fold paralysis; hypopharyngeal neoplasms; salvage therapy; prognosis
• ISSN: 2234-943X; 2234-943X
• DOI: 10.3389/fonc.2020.600599

We aimed to analyze the relationship between the changed status of vocal cord mobility and survival outcomes. Seventy-eight patients with dysfunctional vocal cords and hypopharyngeal carcinomas accepted non-surgical treatment as the initial therapy between May 2009 and December 2016. Vocal cord mobility was assessed before and after the initial non-surgical treatment. The cord mobility status was classified as normal, impaired, and fixed. Patients with improved mobility (IM) (n =56) were retrospectively analyzed for disease-free survival (DFS), recurrence-free survival (RFS), and overall survival (OS) and compared with 22 patients with non-improved mobility (non-IM). Fifty-six (71.8%) patients had improved cord mobility after the initial non-surgical treatment. The non-improved cord mobility was significantly associated with shortened DFS ( 0.005), RFS ( 0.002), and OS ( <0.001). If non-improved cord mobility was regarded as an indicator for local-regional recurrence within 1 year, the sensitivity and the specificity were 60.9%, 87.5% respectively. The multivariate analysis showed that improved cord mobility ( 0.006) and salvage surgery ( 0.015) were both independent protective factors for OS. Changes in cord mobility are a key marker for predicting prognosis. Non-improved cord mobility may indicate a high possibility of a residual tumor, therefore, patients whose cord mobility remains dysfunctional or worsens after non-surgical treatment might need an aggressive salvage strategy.