Squamous cell carcinoma of the hypopharynx: single-institution outcome analysis of a large cohort of patients treated with primary non-surgical approaches.

Introduction: Hypopharyngeal cancers have extensive submucosal spread, high risk of nodal involvement and relatively high propensity of distant metastases. Contemporary paradigms for hypopharyngeal cancers aim to maximize loco-regional control while attempting to preserve laryngo-pharyngeal form and function.

Aims: To retrospectively review outcome of large cohort of patients with hypopharyngeal cancers treated with curative intent radiotherapy with or without systemic chemotherapy in an academic tertiary referral centre.

Material And Methods: Medical records of patients with hypopharyngeal cancers treated with primary non-surgical approaches over a 15-year period were reviewed retrospectively. Loco-regional control (LRC) and disease-free survival (DFS) were considered as outcome measures.

Results: Electronic search of database identified 501 patients with hypopharyngeal cancers treated with definitive radiotherapy. The median age was 55 years (range 20-87 years) and median radiotherapy dose 70 Gy (range 5.4-72 Gy). With a mean follow-up period of 22 months (median 12 months), the 3-year LRC and DFS was 47.1% and 40.9% respectively. Stage (T-stage, N-stage, overall stage grouping), and age influenced outcome significantly. The 3-year LRC for T1-T2 disease was 49.7% versus 43.1% for T3- T4 stage (p0.056). The 3-year DFS was 49.4% and 36.9% respectively (p0.014). The 3-year LRC and DFS for N0; N1; and N2-3 disease was 57.3% & 54.3%; 40.5% & 35.3%; and 33% & 27% respectively with highly significant p-values.

Conclusion: This is an outcome analysis of the largest cohort of patients with hypopharyngeal cancers managed with primary non-surgical approaches. Stage and age remain the most important determinants of outcome.