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Survival Outcome Superiority of Total Pharyngolaryngectomy Compared with Chemoradiotherapy for T4aM0 Hypopharyngeal Squamous Cell Carcinoma: A Nationwide Database Study of Japan

Go Omura, Kohtaro Eguchi, Seiichi Yoshimoto,Yoshitaka Honma,Chihiro Fushimi,Toshihiko Sakai,Yoshifumi Matsumoto,Azusa Sakai, Megumi Kitayama,Daisuke Kawakita, Tadaaki Kirita,Takeshi Kodaira,Munenaga Nakamizo, Ken-ichi Nibu

Annals of Surgical Oncology(2024)

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摘要
The purpose of this study is to elucidate whether total pharyngolaryngectomy (TPL) or chemoradiotherapy (CRT) provides a better prognostic outcome in patients with T4aM0 hypopharyngeal carcinoma (HPSCC) using a nationwide database. All data were obtained from the Head and Neck Cancer Registry of Japan, and information from patients who were newly diagnosed with T4aM0 HPSCC between 2011 and 2015 was extracted. The primary endpoint was disease-specific survival (DSS), and the secondary endpoint was overall survival (OS). The inverse probability of treatment weighting (IPTW) adjustments was used for survival analyses. Our cohort included 1143 patients. The TPL and CRT groups included 724 and 419 patients, respectively. Following IPTW adjustments, both the OS and DSS of the TPL group were significantly longer than those of the CRT group (P = .02 and P = .002, respectively). Survival superiority was demonstrated for patients with T4aM0 HPSCC treated with TPL compared with those treated with CRT.
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关键词
Hypopharyngeal squamous cell carcinoma,Total pharyngolaryngectomy,Chemoradiotherapy,Inverse probability of treatment weighting adjustments,Head and Neck Cancer Registry of Japan
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