Surgery Compared With Non-surgical Treatment In Patients With Hypopharyngeal Cancer: A Meta-analysis

Objective: This study is trying to review and summarize the efficacy of surgery versus non-surgical treatment in patients with hypopharyngeal cancer.Methods: We searched eligible studies is electronic databases,including PubMed,Embase,Cochrane,CNKI,Weipu Data and Wanfang Data till June 2019.The pooled hazard ratios(HR)of survival outcomes and relative risk(RR)of larynx preservation were calculated to compare the value of two treatments in hypopharyngeal cancer.Results: Eleven studies were included,including 2 randomized controlled trials and 9 cohort studies.Surgical treatment could provide overall survival(OS)benefit for hypopharyngeal cancer patients [HR=0.78,95%CI(0.63,0.96)],however,there was no significant difference between patients with locally advanced hypopharyngeal carcinoma[HR=0.73,95%CI(0.51,1.03)].Also,there was no significance in progression free survival(PFS)/ disease free survival(DFS)between two groups[HR=0.83,95%CI(0.42,1.65)].Non-surgical treatment had the advantage of larynxpreservation[RR=0.52,95%CI(0.31,0.87)].Conclusion: The results of this study suggests that surgical treatment may be a better choice for patient with hypopharyngeal cancer,but no survival benefit is observed in patients with locally advanced disease,non-surgical treatment has advantages in larynx preservation.Considering the obvious heterogeneity of the results,more randomized prospective trials are needed in the future.