Predicting Factors for Oncological and Functional Outcome in Hypopharyngeal Cancer.

Objectives/hypothesis: Hypopharyngeal squamous cell carcinoma (SCC) is a rare but aggressive malignancy, with low survival rates and high incidence of tumor and treatment-related morbidity. This study aims to analyze the long-term oncologic and functional outcomes of a large cohort of patients and to determine prognostic factors.

Study Design: Retrospective cohort study.

Methods: The records of all patients diagnosed with hypopharyngeal SCC and treated with curative intent at our tertiary referral center were reviewed. Patient and initial disease characteristics, features, and complications of primary treatment, recurrence patterns, and corresponding treatments and the oncologic and functional long-term outcome were determined.

Results: For a total of 179 patients, primary radiotherapy (RT) was the predominant treatment modality (78%), whereas 22% underwent primary surgery. The median, 2-year, and 5-year overall survival (OS) for the study cohort were 47 months, 64% and 43%. The median survival after first and second relapse was 7 and 6 months, respectively. The 2 and 5-year relapse-free survival (RFS) was 52% and 36%. The median RFS after first relapse and salvage treatment was 9 months. A nodal status of ≥cN2 (HR = 1.89, CI:1.21-3.05, P < .005) and any other primary tumor localization than pyriform sinus (HR = 1.60, CI: 1.04-2.42, P < .05) were identified as independent risk factors for shorter OS and RFS. Regarding functional outcome, the 2- and 5-year laryngectomy-free-survival was 55% and 37%, respectively.

Conclusions: In this large cohort with long-term follow-up, any other primary tumor localization than pyriform sinus and a nodal status of ≥cN2 were identified as risk factors for reduced OS and RFS.

Level Of Evidence: 4 Laryngoscope, 131:E1543-E1549, 2021.