The Presence of Risk Factors and Corresponding Treatment Strategies Post-Surgical Resection in Stage IV Hypopharyngeal Squamous Cell Carcinoma Patients: A Retrospective Cohort Study

Background This study aims to explore the high-risk factors and determine whether adjuvant chemoradiation after surgical resection can benefit stage IV hypopharyngeal squamous cell carcinoma (HSCC) patients.

Methods We conducted a retrospective review covering 267 patients with stage IV HSCC. Propensity score-matched analysis was employed to reduce selection bias.

Results T3-T4 or N2c-N3 stage, positive surgical margin, extracapsular spread and lymphovascular invasion were high-risk factors for Overall survival (OS) in stage IV HSCC patients. For patients possessing high-risk factors, those who received postoperative adjuvant treatment had significantly better OS and recurrence-free survival (RFS) than patients who did not receive the treatment (p-value =0.000 and 0.007, respectively). For patients that received postoperative adjuvant treatment, adjuvant chemoradiation demonstrated better OS and RFS compared to adjuvant radiation (p-value=0.030 and 0.017, respectively). However, for patients without high-risk factors, whether postoperative adjuvant treatment was received showed no significant impact on OS and RFS (p-value=0.776 and 0.847, respectively) Conclusions: Adjuvant treatments looks to be necessary for stage IV HSCC patients that possess high-risk factors of pT3 and pT4 stages, N2c and N3 stages, positive surgical margin, extracapsular spread and lymphovascular invasion. For these patients, postoperative adjuvant chemotherapy is preferred. Conversely, for patients without high-risk factors, observation and regular re-examination is sufficient post tumour resection.

This study was supported by the Science and Technology Innovation Project of Shanghai Shen-kang Hospital Clinical Development Center (Grand no. SHDC12015114); The Science and Technology Commission of Shanghai Municipality (Grand no. 16411950100); The National Natural Science Foundation of China (Grand nos. 81772878, 30801283, and 30972691); The Shanghai Science and Technology Development Funds (Grant nos. 09QA1401000, 10QA1405900, and 14411961900); the Training Program of the Excellent Young Talents of Shanghai Municipal Health System (Grant nos. XYQ2011055 and XYQ2011015); and the Shanghai Municipal Science and Technology Foundation (Grand no. 11JC1410802).

Poster-PDF A-1134.PDF

Publication History

Article published online:
10 June 2020