Prognosis Of Different Managements For Moderately To Very Advanced Hypopharyngeal Carcinoma

Objective:To identify and compare the overall prognosis of surgical and non-surgical management on moderately to very advanced(staging Ⅲ to Ⅳ)hypopharyngeal carcinoma under the guidance of multidisciplinary team.Methods:Review all the inpatient cases of hypopharyngeal carcinoma staging Ⅲ to Ⅳfrom the Head and Neck Surgery Department,Radiotherapy Department or Oncology Department of Cancer Hospital Chinese Academy of Medical Sciences between January 2010 and January 2016,including age,gender,the site of tumor,staging,treatment strategy,etc.,following-up patients by telephone,and then analyze the prognosis of different ways of management.Results:In the aspect of demographic data and staging,there was no significant difference between the the surgical management group and the non-surgical management group(p=0.9821),but the site of tumor matters(p=0.0078).In the the surgical management group,postoperative pathological staging of 69 cases(63.9%)of patients altered comparing with preoperative staging,but there was no significant difference between them.The 1-year overall survival rates of the two groups were 87%and 93%,the 3-year overall survival rates were 67%and 55%,and the 5-year overall survival rates were 61%and 43%,and there was no significant statistical difference(p=0.239)in Wilcoxon rank sum test.In the the non-surgical management group,there was significant difference(p=0.007)between the chemo-radiotherapy subgroup and the induction chemotherapy subgroup on clinical prognostic staging,and the 5-year overall survival rates of the two subgroups were 45%and 35%,respectively,the clinical prognostic staging of the induction chemotherapy subgroup was generally higher.Whether with or without concurrent targeted drug therapy had no significant effect on the overall survival rate of patients in the the non-surgical management group(p=0.489).Conclusion:Either surgery-based or non-surgery-based comprehensive treatment for moderately to very advanced hypopharyngeal carcinoma has great diversity.In this retrospective study,the short-term overall survival rate of the non-surgical management group was higher,and on the contrary the long-term overall survival rate of the surgical treatment group showed considerable advantage.The management strategies was related to the site of tumor,which reflects both the indications for different treatment and the personal preference of patients.