Distinct Failure Patterns in Hypopharyngeal Cancer Patients Receiving Surgery-Based Versus Radiation-Based Treatment
Background To cure advanced hypopharyngeal squamous cell carcinoma (HPSCC), primary operation followed by adjuvant (chemo-)radiotherapy (OP-CRT) or definitive chemoradiation (CCRT) are the two primary options. This study aimed to compare the failure patterns and long-term survival outcomes of HPSCC...
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| Published in | Annals of surgical oncology Vol. 30; no. 2; pp. 1169 - 1181 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Cham
Springer International Publishing
01.02.2023
Springer Nature B.V |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1068-9265 1534-4681 1534-4681 |
| DOI | 10.1245/s10434-022-12744-1 |
Cover
| Abstract | Background
To cure advanced hypopharyngeal squamous cell carcinoma (HPSCC), primary operation followed by adjuvant (chemo-)radiotherapy (OP-CRT) or definitive chemoradiation (CCRT) are the two primary options. This study aimed to compare the failure patterns and long-term survival outcomes of HPSCC patients treated with these two strategies.
Patients and Methods
From 2007 to 2015, 198 pathologically confirmed HPSCC patients receiving either OP-CRT or CCRT were retrospectively reviewed. Failure patterns and survival outcomes stratified by the 7th American Joint Committee on Cancer staging system and treatment modalities were compared.
Results
One hundred and eighty-nine patients (95.4%) were stage III/IV and 62 patients (31.3%) received OP-CRT. Median follow-up duration was 4.9 years. Compared with CCRT, OP-CRT provided better 3-year local relapse-free survival for T3 (93 vs 48%,
p
< 0.0001), T4a (88 vs 37%,
p
= 0.0005) and better 3-year regional relapse-free survival for N2b+2c (93 vs 60%,
p
< 0.0001). Of note, for stage IVA subjects, OP-CRT provided better 3-year loco-regional relapse-free survival (85 vs 37%,
p
< 0.0001), marginal poor 3-year distant metastasis-free survival (62 vs 79%,
p
= 0.06), but comparable 3-year OS (52 vs 44%,
p
= 0.37) and 5-year OS (44 vs 31%,
p
= 0.15) compared with CCRT.
Conclusions
For patients with advanced HPSCC, although OP-CRT and CCRT provided similar overall survival, failure patterns were distinct. OP-CRT provided better loco-regional control but was more likely to encounter distant metastases than CCRT. The detailed analysis of failure patterns will pave the way to improve this devastating disease. |
|---|---|
| AbstractList | To cure advanced hypopharyngeal squamous cell carcinoma (HPSCC), primary operation followed by adjuvant (chemo-)radiotherapy (OP-CRT) or definitive chemoradiation (CCRT) are the two primary options. This study aimed to compare the failure patterns and long-term survival outcomes of HPSCC patients treated with these two strategies. PATIENTS AND METHODS: From 2007 to 2015, 198 pathologically confirmed HPSCC patients receiving either OP-CRT or CCRT were retrospectively reviewed. Failure patterns and survival outcomes stratified by the 7th American Joint Committee on Cancer staging system and treatment modalities were compared.BACKGROUNDTo cure advanced hypopharyngeal squamous cell carcinoma (HPSCC), primary operation followed by adjuvant (chemo-)radiotherapy (OP-CRT) or definitive chemoradiation (CCRT) are the two primary options. This study aimed to compare the failure patterns and long-term survival outcomes of HPSCC patients treated with these two strategies. PATIENTS AND METHODS: From 2007 to 2015, 198 pathologically confirmed HPSCC patients receiving either OP-CRT or CCRT were retrospectively reviewed. Failure patterns and survival outcomes stratified by the 7th American Joint Committee on Cancer staging system and treatment modalities were compared.One hundred and eighty-nine patients (95.4%) were stage III/IV and 62 patients (31.3%) received OP-CRT. Median follow-up duration was 4.9 years. Compared with CCRT, OP-CRT provided better 3-year local relapse-free survival for T3 (93 vs 48%, p < 0.0001), T4a (88 vs 37%, p = 0.0005) and better 3-year regional relapse-free survival for N2b+2c (93 vs 60%, p < 0.0001). Of note, for stage IVA subjects, OP-CRT provided better 3-year loco-regional relapse-free survival (85 vs 37%, p < 0.0001), marginal poor 3-year distant metastasis-free survival (62 vs 79%, p = 0.06), but comparable 3-year OS (52 vs 44%, p = 0.37) and 5-year OS (44 vs 31%, p = 0.15) compared with CCRT.RESULTSOne hundred and eighty-nine patients (95.4%) were stage III/IV and 62 patients (31.3%) received OP-CRT. Median follow-up duration was 4.9 years. Compared with CCRT, OP-CRT provided better 3-year local relapse-free survival for T3 (93 vs 48%, p < 0.0001), T4a (88 vs 37%, p = 0.0005) and better 3-year regional relapse-free survival for N2b+2c (93 vs 60%, p < 0.0001). Of note, for stage IVA subjects, OP-CRT provided better 3-year loco-regional relapse-free survival (85 vs 37%, p < 0.0001), marginal poor 3-year distant metastasis-free survival (62 vs 79%, p = 0.06), but comparable 3-year OS (52 vs 44%, p = 0.37) and 5-year OS (44 vs 31%, p = 0.15) compared with CCRT.For patients with advanced HPSCC, although OP-CRT and CCRT provided similar overall survival, failure patterns were distinct. OP-CRT provided better loco-regional control but was more likely to encounter distant metastases than CCRT. The detailed analysis of failure patterns will pave the way to improve this devastating disease.CONCLUSIONSFor patients with advanced HPSCC, although OP-CRT and CCRT provided similar overall survival, failure patterns were distinct. OP-CRT provided better loco-regional control but was more likely to encounter distant metastases than CCRT. The detailed analysis of failure patterns will pave the way to improve this devastating disease. Background To cure advanced hypopharyngeal squamous cell carcinoma (HPSCC), primary operation followed by adjuvant (chemo-)radiotherapy (OP-CRT) or definitive chemoradiation (CCRT) are the two primary options. This study aimed to compare the failure patterns and long-term survival outcomes of HPSCC patients treated with these two strategies. Patients and Methods From 2007 to 2015, 198 pathologically confirmed HPSCC patients receiving either OP-CRT or CCRT were retrospectively reviewed. Failure patterns and survival outcomes stratified by the 7th American Joint Committee on Cancer staging system and treatment modalities were compared. Results One hundred and eighty-nine patients (95.4%) were stage III/IV and 62 patients (31.3%) received OP-CRT. Median follow-up duration was 4.9 years. Compared with CCRT, OP-CRT provided better 3-year local relapse-free survival for T3 (93 vs 48%, p < 0.0001), T4a (88 vs 37%, p = 0.0005) and better 3-year regional relapse-free survival for N2b+2c (93 vs 60%, p < 0.0001). Of note, for stage IVA subjects, OP-CRT provided better 3-year loco-regional relapse-free survival (85 vs 37%, p < 0.0001), marginal poor 3-year distant metastasis-free survival (62 vs 79%, p = 0.06), but comparable 3-year OS (52 vs 44%, p = 0.37) and 5-year OS (44 vs 31%, p = 0.15) compared with CCRT. Conclusions For patients with advanced HPSCC, although OP-CRT and CCRT provided similar overall survival, failure patterns were distinct. OP-CRT provided better loco-regional control but was more likely to encounter distant metastases than CCRT. The detailed analysis of failure patterns will pave the way to improve this devastating disease. To cure advanced hypopharyngeal squamous cell carcinoma (HPSCC), primary operation followed by adjuvant (chemo-)radiotherapy (OP-CRT) or definitive chemoradiation (CCRT) are the two primary options. This study aimed to compare the failure patterns and long-term survival outcomes of HPSCC patients treated with these two strategies. PATIENTS AND METHODS: From 2007 to 2015, 198 pathologically confirmed HPSCC patients receiving either OP-CRT or CCRT were retrospectively reviewed. Failure patterns and survival outcomes stratified by the 7th American Joint Committee on Cancer staging system and treatment modalities were compared. One hundred and eighty-nine patients (95.4%) were stage III/IV and 62 patients (31.3%) received OP-CRT. Median follow-up duration was 4.9 years. Compared with CCRT, OP-CRT provided better 3-year local relapse-free survival for T3 (93 vs 48%, p < 0.0001), T4a (88 vs 37%, p = 0.0005) and better 3-year regional relapse-free survival for N2b+2c (93 vs 60%, p < 0.0001). Of note, for stage IVA subjects, OP-CRT provided better 3-year loco-regional relapse-free survival (85 vs 37%, p < 0.0001), marginal poor 3-year distant metastasis-free survival (62 vs 79%, p = 0.06), but comparable 3-year OS (52 vs 44%, p = 0.37) and 5-year OS (44 vs 31%, p = 0.15) compared with CCRT. For patients with advanced HPSCC, although OP-CRT and CCRT provided similar overall survival, failure patterns were distinct. OP-CRT provided better loco-regional control but was more likely to encounter distant metastases than CCRT. The detailed analysis of failure patterns will pave the way to improve this devastating disease. BackgroundTo cure advanced hypopharyngeal squamous cell carcinoma (HPSCC), primary operation followed by adjuvant (chemo-)radiotherapy (OP-CRT) or definitive chemoradiation (CCRT) are the two primary options. This study aimed to compare the failure patterns and long-term survival outcomes of HPSCC patients treated with these two strategies.Patients and MethodsFrom 2007 to 2015, 198 pathologically confirmed HPSCC patients receiving either OP-CRT or CCRT were retrospectively reviewed. Failure patterns and survival outcomes stratified by the 7th American Joint Committee on Cancer staging system and treatment modalities were compared.ResultsOne hundred and eighty-nine patients (95.4%) were stage III/IV and 62 patients (31.3%) received OP-CRT. Median follow-up duration was 4.9 years. Compared with CCRT, OP-CRT provided better 3-year local relapse-free survival for T3 (93 vs 48%, p < 0.0001), T4a (88 vs 37%, p = 0.0005) and better 3-year regional relapse-free survival for N2b+2c (93 vs 60%, p < 0.0001). Of note, for stage IVA subjects, OP-CRT provided better 3-year loco-regional relapse-free survival (85 vs 37%, p < 0.0001), marginal poor 3-year distant metastasis-free survival (62 vs 79%, p = 0.06), but comparable 3-year OS (52 vs 44%, p = 0.37) and 5-year OS (44 vs 31%, p = 0.15) compared with CCRT.ConclusionsFor patients with advanced HPSCC, although OP-CRT and CCRT provided similar overall survival, failure patterns were distinct. OP-CRT provided better loco-regional control but was more likely to encounter distant metastases than CCRT. The detailed analysis of failure patterns will pave the way to improve this devastating disease. |
| Author | Chang, Chan-Chi Yen, Chia-Jui Su, Yu-Chu Chang, Jeffrey S. Lin, Yu-Hsuan Lai, Yu-Hsuan Huang, Cheng-Chih Hsiao, Jenn-Ren Ou, Chun-Yen Chen, Yu-Shan Lee, Wei-Ting Hsueh, Wei-Ting Tsai, Sen-Tien Wu, Shang-Yin Jiang, Shih-Sheng Wu, Yuan-Hua Lin, Chen-Lin |
| Author_xml | – sequence: 1 givenname: Yu-Hsuan surname: Lin fullname: Lin, Yu-Hsuan organization: Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital – sequence: 2 givenname: Jenn-Ren surname: Hsiao fullname: Hsiao, Jenn-Ren email: hsiaojr@mail.ncku.edu.tw organization: Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University – sequence: 3 givenname: Yuan-Hua surname: Wu fullname: Wu, Yuan-Hua organization: Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Department of Radiation Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University – sequence: 4 givenname: Jeffrey S. surname: Chang fullname: Chang, Jeffrey S. organization: National Institute of Cancer Research, National Health Research Institutes – sequence: 5 givenname: Chun-Yen surname: Ou fullname: Ou, Chun-Yen organization: Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University – sequence: 6 givenname: Wei-Ting surname: Lee fullname: Lee, Wei-Ting organization: Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University – sequence: 7 givenname: Cheng-Chih surname: Huang fullname: Huang, Cheng-Chih organization: Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University – sequence: 8 givenname: Chan-Chi surname: Chang fullname: Chang, Chan-Chi organization: Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University – sequence: 9 givenname: Yu-Hsuan surname: Lai fullname: Lai, Yu-Hsuan organization: Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Department of Radiation Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University – sequence: 10 givenname: Sen-Tien surname: Tsai fullname: Tsai, Sen-Tien organization: Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University – sequence: 11 givenname: Wei-Ting surname: Hsueh fullname: Hsueh, Wei-Ting organization: Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Department of Radiation Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University – sequence: 12 givenname: Chia-Jui surname: Yen fullname: Yen, Chia-Jui organization: Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University – sequence: 13 givenname: Chen-Lin surname: Lin fullname: Lin, Chen-Lin organization: Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University – sequence: 14 givenname: Yu-Shan surname: Chen fullname: Chen, Yu-Shan organization: Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University – sequence: 15 givenname: Shih-Sheng surname: Jiang fullname: Jiang, Shih-Sheng organization: National Institute of Cancer Research, National Health Research Institutes – sequence: 16 givenname: Yu-Chu surname: Su fullname: Su, Yu-Chu organization: Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Clinical Medicine Research Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University – sequence: 17 givenname: Shang-Yin surname: Wu fullname: Wu, Shang-Yin email: wusy.tw@gmail.com organization: Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University |
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| PublicationDecade | 2020 |
| PublicationPlace | Cham |
| PublicationPlace_xml | – name: Cham – name: United States – name: New York |
| PublicationTitle | Annals of surgical oncology |
| PublicationTitleAbbrev | Ann Surg Oncol |
| PublicationTitleAlternate | Ann Surg Oncol |
| PublicationYear | 2023 |
| Publisher | Springer International Publishing Springer Nature B.V |
| Publisher_xml | – name: Springer International Publishing – name: Springer Nature B.V |
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chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancerN Engl J Med.1991324241685169010.1056/NEJM199106133242402 MellorsKYeXVan Den BrandeJComparison of prophylactic percutaneous endoscopic gastrostomy with reactive enteral nutrition in patients with head and neck cancer undergoing radiotherapy or chemoradiotherapy: a systematic reviewClin Nutr ESPEN.202146879810.1016/j.clnesp.2021.09.724 LeeMSHoHCHsiaoSHHwangJHLeeCCHungSKTreatment results and prognostic factors in locally advanced hypopharyngeal cancerActa Otolaryngol.2008128110310910.1080/00016480701387116 CrowderSLDouglasKGYanina PepinoMSarmaKPArthurAENutrition impact symptoms and associated outcomes in post-chemoradiotherapy head and neck cancer survivors: a systematic reviewJ Cancer Surviv.201812447949410.1007/s11764-018-0687-7 TsouYALinMHHuaCHSurvival outcome by early chemoradiation therapy salvage or early surgical salvage for the treatment of hypopharyngeal cancerOtolaryngol Head Neck Surg.2007137571171610.1016/j.otohns.2007.07.022 HabibAManagement of advanced hypopharyngeal carcinoma: systematic review of survival following surgical and non-surgical treatmentsJ Laryngol Otol.201813253854001:STN:280:DC%2BC1MbmtFOquw%3D%3D10.1017/S0022215118000555 KimJWKimMSKimSHDefinitive chemoradiotherapy versus surgery followed by adjuvant radiotherapy in resectable stage III/IV hypopharyngeal cancerCancer Res Treat.201648145531:CAS:528:DC%2BC2sXlvVais7k%3D10.4143/crt.2014.340 McClellandS3rdAndrewsJZChaudhryHTeckieSGoenkaAProphylactic versus reactive gastrostomy tube placement in advanced head and neck cancer treated with definitive chemoradiotherapy: a systematic reviewOral Oncol.201887778110.1016/j.oraloncology.2018.10.028 GarneauJCBakstRLMilesBAHypopharyngeal cancer: a state of the art reviewOral Oncol.20188624425010.1016/j.oraloncology.2018.09.025 JangJYKimEHChoJComparison of oncological and functional outcomes between initial surgical versus non-surgical treatments for hypopharyngeal cancerAnn Surg Oncol.20162362054206110.1245/s10434-016-5088-4 XiangMGensheimerMFPollomELProlongation of definitive head and neck cancer radiotherapy: survival impact and predisposing factorsRadiother Oncol.202115620120810.1016/j.radonc.2020.12.025 GujralDMNuttingCMPatterns of failure, treatment outcomes and late toxicities of head and neck cancer in the current era of IMRTOral Oncol.20188622523310.1016/j.oraloncology.2018.09.011 LefebvreJLChevalierDLuboinskiBKirkpatrickAColletteLSahmoudTLarynx preservation in pyriform sinus cancer: preliminary results of a European organization for research and treatment of cancer phase III trial EORTC head and neck cancer cooperative groupJ Natl Cancer Inst.199688138908991:STN:280:DyaK283msV2qsw%3D%3D10.1093/jnci/88.13.890 LeeWTHsiaoJROuCYThe influence of prediagnosis alcohol consumption and the polymorphisms of ethanol-metabolizing genes on the survival of head and neck cancer patientsCancer Epidemiol Biomarkers 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dehydrogenase-aldehyde dehydrogenase polymorphism on clinical outcome in patients with hypopharyngeal cancerHead Neck.201840477077710.1002/hed.25050 LangiusJABakkerSRietveldDHCritical weight loss is a major prognostic indicator for disease-specific survival in patients with head and neck cancer receiving radiotherapyBr J Cancer.20131095109310991:STN:280:DC%2BC3sfotVejsg%3D%3D10.1038/bjc.2013.458 HuangCELuCHChenPTEfficacy and safety of dose-modified docetaxel plus cisplatin-based induction chemotherapy in Asian patients with locally advanced head and neck cancerJ Clin Pharm Ther.20123733423471:CAS:528:DC%2BC38XhtFSqsrfF10.1111/j.1365-2710.2011.01306.x NewmanJRConnollyTMIllingEAKilgoreMLLocherJLCarrollWRSurvival trends in hypopharyngeal cancer: a population-based reviewLaryngoscope2015125362462910.1002/lary.24915 PhilipsRSeimNMarcinowAThe high stakes of head and neck surgery following radiation and chemotherapy - an assessment of complications and survivalOral 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for locally advanced head and neck carcinomas: results of the GORTEC 2007–01 phase III randomized trialJ Clin Oncol.2018762518 ChangJSHsiaoJRChenCHALDH2 polymorphism and alcohol-related cancers in Asians: a public health perspectiveJ JF Petersen (12744_CR4) 2018; 275 YJ Kim (12744_CR33) 2018; 7 P Pracy (12744_CR34) 2016; 130 EJ Chung (12744_CR48) 2019; 89 A Habib (12744_CR5) 2018; 132 DJ Adelstein (12744_CR15) 2003; 21 GT Wolf (12744_CR26) 1991; 324 RP Takes (12744_CR7) 2012; 34 R Philips (12744_CR47) 2019; 94 JR Newman (12744_CR3) 2015; 125 G Numico (12744_CR51) 2020; 139 A Paccagnella (12744_CR18) 1994; 86 J Heukelom (12744_CR37) 2019; 161 GT Wolf (12744_CR35) 2017; 143 12744_CR11 A Argiris (12744_CR23) 2008; 371 DM Gujral (12744_CR24) 2018; 86 CJ Yang (12744_CR46) 2015; 121 HM Wang (12744_CR12) 2002; 94 MY Hsieh (12744_CR21) 2018; 25 S Iwae (12744_CR28) 2017; 22 JA Bonner (12744_CR16) 2006; 354 MO Avinçsal (12744_CR43) 2018; 40 S McClelland 3rd (12744_CR39) 2018; 87 BN Harris (12744_CR10) 2015; 141 CE Huang (12744_CR19) 2012; 37 12744_CR49 C Beauvillain (12744_CR9) 1997; 107 GK Beckmann (12744_CR14) 2005; 27 HM Wang (12744_CR20) 2005; 16 AA Forastiere (12744_CR13) 2003; 349 V Bar-Ad (12744_CR25) 2014; 41 PJ Bradley (12744_CR22) 2019; 27 CT Cheng (12744_CR31) 2017; 39 YA Tsou (12744_CR29) 2007; 137 12744_CR1 12744_CR36 K Mellors (12744_CR38) 2021; 46 Y Tao (12744_CR17) 2018; 7 JW Kim (12744_CR30) 2016; 48 WT Lee (12744_CR42) 2019; 28 JY Jang (12744_CR32) 2016; 23 JS Chang (12744_CR44) 2017; 24 RL Chai (12744_CR50) 2013; 139 JL Lefebvre (12744_CR8) 1996; 88 JA Langius (12744_CR40) 2013; 109 JC Garneau (12744_CR6) 2018; 86 SL Crowder (12744_CR45) 2018; 12 DI Kwon (12744_CR2) 2019; 41 MS Lee (12744_CR27) 2008; 128 M Xiang (12744_CR41) 2021; 156 |
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To cure advanced hypopharyngeal squamous cell carcinoma (HPSCC), primary operation followed by adjuvant (chemo-)radiotherapy (OP-CRT) or definitive... To cure advanced hypopharyngeal squamous cell carcinoma (HPSCC), primary operation followed by adjuvant (chemo-)radiotherapy (OP-CRT) or definitive... BackgroundTo cure advanced hypopharyngeal squamous cell carcinoma (HPSCC), primary operation followed by adjuvant (chemo-)radiotherapy (OP-CRT) or definitive... |
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| SubjectTerms | Chemoradiotherapy Failure analysis Head and Neck Oncology Humans Hypopharyngeal Neoplasms - surgery Medicine Medicine & Public Health Metastases Neoplasm Recurrence, Local - therapy Neoplasm Staging Oncology Patients Radiation therapy Retrospective Studies Squamous cell carcinoma Surgery Surgical Oncology Throat cancer |
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| Title | Distinct Failure Patterns in Hypopharyngeal Cancer Patients Receiving Surgery-Based Versus Radiation-Based Treatment |
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