Top

International Journal of Clinical Oncology

Published in:

01-04-2015 | Original Article

Disease control and clinicopathological prognostic factors of total pharyngolaryngectomy for hypopharyngeal cancer: a single-center study

Authors: Go Omura, Mizuo Ando, Yuki Saito, Kenya Kobayashi, Tatsuya Yamasoba, Takahiro Asakage

Published in: International Journal of Clinical Oncology | Issue 2/2015

Abstract

Background

Total pharyngolaryngectomy (TPL) is a conventional and standard surgical method for locoregional control of advanced hypopharyngeal cancer (HPC). This study aimed to define the clinicopathological prognostic factors of TPL by evaluating our surgical experience of TPL in the treatment of HPCs.

Methods

We retrospectively reviewed the clinical charts of patients with HPC who were treated between 1995 and 2011 at the University of Tokyo Hospital and enrolled 119 patients who underwent TPL as an initial curative treatment.

Results

The mean follow-up period was 46 months (range, 2–164 months). The 5-year overall survival (OS), disease-specific survival (DSS), locoregional control rates, and relapse-free survival for all patients were 44, 53, 76, and 50 %, respectively. In multivariate analysis, the number of ≥4 metastatic lymph nodes (LNs) was a significant poor prognostic factor for both OS and DSS (p = 0.03 and p = 0.01). Patients with moderate to severe comorbidities had poor prognoses for OS (p = 0.002). In addition, patients with the number of ≥4 metastatic LNs had a higher incidence of distant metastases (p < 0.0001).

Conclusions

The locoregional control rate following TPL was acceptable and the number of metastatic LNs was associated with the incidence of distant metastases.

Pignon JP, Bourhis J, Domenge C et al (2000) Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data. Lancet 355:949–955CrossRefPubMed

Posner MR, Hershock DM, Blajman CR et al (2007) Cisplatin and fluorouracil alone or with docetaxel in head and neck cancer. N Engl J Med 357:1705–1715CrossRefPubMed

Posner MR, Norris CM, Wirth LJ et al (2009) Sequential therapy for the locally advanced larynx and hypopharynx cancer subgroup in TAX 324—survival, surgery, and organ preservation. Ann Oncol 20:921–927CrossRefPubMed

Center for Cancer Control and Information Services, National Cancer Center, Japan. http://ganjoho.jp/professional/statistics/backnumber/2013_jp.html

Brockstein B, Haraf DJ, Rademaker AW et al (2004) Patterns of failure, prognostic factors and survival in locoregionally advanced head and neck cancer treated with concomitant chemoradiotherapy—a 9-year, 337-patient, multi-institutional experience. Ann Oncol 15:1179–1186CrossRefPubMed

Hilgers FJM, Ackerstaff AH, Balm AJM et al (1997) Development and clinical evaluation of a second-generation voice prosthesis (Provox2), designed for anterograde and retrograde insertion. Acta Otolaryngol 117:889–896CrossRefPubMed

Terada T, Saeki N, Toh K et al (2007) Voice rehabilitation with Provox2™ voice prosthesis following total laryngectomy for laryngeal and hypopharyngeal carcinoma. Auris Nasus Larynx 34:65–71CrossRefPubMed

Wang WL, Lee CT, Hwang TZ et al (2011) Risk factors for developing synchronous esophageal neoplasia in patients with head and neck cancer. Head Neck 33:77–81CrossRefPubMed

Hamajima N, Takezaki T, Tajima K (2002) Allele frequencies of 25 polymorphisms pertaining to cancer risk for Japanese, Koreans and Chinese. Asian Pac J Cancer Prev 3:197–206PubMed

10.

Asakage T, Yokoyama A, Haneda T et al (2006) Genetic polymorphisms of alcohol and aldehyde dehydrogenases, and drinking, smoking and diet in Japanese men with oral and pharyngeal squamous cell carcinoma. Carcinogenesis 28:865–874CrossRefPubMed

11.

Kaplan MH, Feinstein AR (1974) The importance of classifying initial comorbidity in evaluating the outcome of diabetes mellitus. J Chronic Dis 27:387–404CrossRefPubMed

12.

Piccirillo JF (2000) Importance of comorbidity in head and neck cancer. Laryngoscope 110:593–602CrossRefPubMed

13.

Rogers SN, Aziz A, Lowe D et al (2005) Feasibility study of the retrospective use of the Adult Comorbidity Evaluation Index (ACE-27) in patients with cancer of the head and neck who had radiotherapy. Br J Oral Maxillofac Surg 43:511–512CrossRef

14.

Paleri V, Wight RG (2002) Applicability of the adult comorbidity evaluation—27 and the Charlson indexes to assess comorbidity by notes extraction in a cohort of United Kingdom patients with head and neck cancer: a retrospective study. J Laryngol Otol 116:200–205PubMed

15.

Sanabria A, Carvalho AL, Vartanian JG et al (2007) Comorbidity is a prognostic factor in elderly patients with head and neck cancer. Ann Surg Oncol 14:1449–1457CrossRefPubMed

16.

Ferrier MB, Spuesens EB, Le Cessie S et al (2005) Comorbidity as a major risk factor for mortality and complications in head and neck surgery. Arch Otolaryngol Head Neck Surg 131:27–32CrossRefPubMed

17.

Homma A, Sakashita T, Oridate N et al (2010) Importance of comorbidity in hypopharyngeal cancer. Head Neck 32:148–153PubMed

18.

Pignon JP, le Maitre A, Maillard E et al (2009) Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiother Oncol 92:4–14CrossRefPubMed

19.

Theile DR, Robinson DW, Theile DE et al (1995) Free jejunal interposition reconstruction after pharyngolaryngectomy: 201 consecutive cases. Head Neck 17:83–88CrossRefPubMed

20.

Bova R, Goh R, Poulson M et al (2005) Total pharyngolaryngectomy for squamous cell carcinoma of hypopharynx: a review. Laryngoscope 115:864–869CrossRefPubMed

21.

Chu PY, Wang LW, Chang SY et al (2004) Surgical treatment of squamous cell carcinoma of the hypopharynx: analysis of treatment results, failure patterns, and prognostic factors. J Laryngol Otol 118:443–449PubMed

22.

Triboulet JP, Mariette C, Chevailier D et al (2001) Surgical management of carcinoma of the hypopharynx and cervical esophagus: analysis of 209 cases. Arch Surg 136:1164–1170CrossRefPubMed

23.

Rapoport A, Franco EL (1993) Prognostic factors and relative risk in hypopharyngeal cancer-related parameters concerning stage, therapeutics and evolution. Rev Paul Med 111:337–343PubMed

24.

Baghi M, Bisdas S, Engels K et al (2007) Prognostic relevance of volumetric analysis in tumour specimens of hypopharyngeal cancer. Clin Otolaryngol 32:372–377CrossRefPubMed

25.

Cooper JS, Pajak TF, Forastiere AA et al (1998) Precisely defining high-risk operable head and neck tumors based on RTOG #85-03 and #88-24: targets for postoperative radiochemotherapy? Head Neck 20:588–594CrossRefPubMed

26.

Cooper JS, Pajak TF, Forastiere AA et al (2004) Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med 350:1937–1944CrossRefPubMed

27.

Cooper JS, Pajak TF, Forastiere AA et al (2012) Long-term follow-up of the RTOG 9501/intergroup phase III trial: postoperative concurrent radiation therapy and chemotherapy in high-risk squamous cell carcinoma of the head and neck. Radiat Oncol Biol Phys 84:1198–1205CrossRef

28.

Leemans CR, Tiwari R, Nauta JJ et al (1993) Regional lymph node involvement and its significance in the development of distant metastases in head and neck carcinoma. Cancer 71:452–456CrossRefPubMed

29.

Alvi A, Johnson JT (1997) Development of distant metastasis after treatment of advanced-stage head and neck cancer. Head Neck 19:500–505CrossRefPubMed

30.

Jacobs JR, Ahmad K, Casiano R et al (1993) Implications of positive surgical margins. Laryngoscope 103:64–68CrossRefPubMed

Title: Disease control and clinicopathological prognostic factors of total pharyngolaryngectomy for hypopharyngeal cancer: a single-center study
Authors: Go Omura
Mizuo Ando
Yuki Saito
Kenya Kobayashi
Tatsuya Yamasoba
Takahiro Asakage
Publication date: 01-04-2015
Publisher: Springer Japan
Published in: International Journal of Clinical Oncology / Issue 2/2015
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-014-0709-z

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 2/2015

Japanese Society for Cancer of the Colon and Rectum (JSCCR) Guidelines 2014 for treatment of colorectal cancer

The key role of calreticulin in immunomodulation induced by chemotherapeutic agents

Comparison of diameter-axial-polar nephrometry and RENAL nephrometry score for treatment decision-making in patients with small renal mass

Clinical benefit of sequential use of endocrine therapies for metastatic breast cancer

Nationwide Japanese Prostate Cancer Outcome Study of Permanent Iodine-125 Seed Implantation (J-POPS)

A phase I trial of preoperative S-1 in combination with oxaliplatin and pelvic radiation for lower rectal cancer with T4 and lateral pelvic lymph node metastasis

Keynote webinar | Spotlight on antibody–drug conjugates in cancer