Treatment sequence and survival in locoregionally advanced hypopharyngeal cancer: A surveillance, epidemiology, and end results–based study
Objectives/Hypothesis The objective of this study was to examine the association between modality of primary treatment and survival among patients with locoregionally advanced hypopharyngeal cancer. Study Design Retrospective cohort. Methods There were 2,328 adult patients diagnosed with stage III o...
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| Veröffentlicht in: | The Laryngoscope 2020-11, Vol.130 (11), p.2611-2621 |
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| creator | Hochfelder, Colleen G. McGinn, Aileen P. Mehta, Vikas Castellucci, Enrico Kabarriti, Rafi Ow, Thomas J. |
| description | Objectives/Hypothesis
The objective of this study was to examine the association between modality of primary treatment and survival among patients with locoregionally advanced hypopharyngeal cancer.
Study Design
Retrospective cohort.
Methods
There were 2,328 adult patients diagnosed with stage III or IV, M0, hypopharyngeal squamous cell carcinoma identified within the Surveillance, Epidemiology and End Results (SEER) registry (years 2004–2015). Patients who received primary chemoradiation (CRT) were compared to those who received surgery with either adjuvant radiation therapy (S + RT), or surgery with adjuvant CRT (S + CRT). The latter primary surgery group (S + Adj) was also analyzed collectively. Overall survival (OS) and disease‐specific survival (DSS) were assessed using Kaplan‐Meier analyses and Cox regression models using a propensity score to adjust for factors associated with treatment allocation.
Results
Median survival was 20 months (interquartile range [IQR] = 10–45) with CRT and 25 months (IQR = 10–47) with S + Adj (P |
| doi_str_mv | 10.1002/lary.28452 |
| format | Article |
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The objective of this study was to examine the association between modality of primary treatment and survival among patients with locoregionally advanced hypopharyngeal cancer.
Study Design
Retrospective cohort.
Methods
There were 2,328 adult patients diagnosed with stage III or IV, M0, hypopharyngeal squamous cell carcinoma identified within the Surveillance, Epidemiology and End Results (SEER) registry (years 2004–2015). Patients who received primary chemoradiation (CRT) were compared to those who received surgery with either adjuvant radiation therapy (S + RT), or surgery with adjuvant CRT (S + CRT). The latter primary surgery group (S + Adj) was also analyzed collectively. Overall survival (OS) and disease‐specific survival (DSS) were assessed using Kaplan‐Meier analyses and Cox regression models using a propensity score to adjust for factors associated with treatment allocation.
Results
Median survival was 20 months (interquartile range [IQR] = 10–45) with CRT and 25 months (IQR = 10–47) with S + Adj (P < .001). S + Adj had higher‐grade cancers and more advanced T staging (P < .001). S + CRT was associated with longer OS (hazard ratio [HR] = 0.70, 95% confidence interval [CI]: 0.59‐0.84) and DSS (HR = 0.66, 95% CI: 0.54‐0.82) after adjusting for age, gender, race, subsite, grade, and stage. S + RT was associated with longer DSS than CRT (HR = 0.75, 95% CI: 0.57‐0.99) but not OS (HR = 0.82, 95% CI: 0.66‐1.04). S + Adj was associated with longer DSS in T1/T2 disease (P = .04) and T4 disease (P = .0003), but did not reach significance among patients with T3 disease (P = .06).
Conclusions
Among patients with advanced hypopharyngeal cancer reported in the SEER database, treatment with S + Adj was associated with longer DSS and OS compared to those treated with primary CRT.
Level of Evidence
2b Laryngoscope, 130:2611–2621, 2020</description><identifier>ISSN: 0023-852X</identifier><identifier>EISSN: 1531-4995</identifier><identifier>DOI: 10.1002/lary.28452</identifier><identifier>PMID: 31821572</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Aged ; Cancer therapies ; Chemoradiotherapy - mortality ; Chemoradiotherapy, Adjuvant - mortality ; Epidemiology ; Female ; Head & neck cancer ; Humans ; hypopharyngeal neoplasms ; Hypopharyngeal Neoplasms - mortality ; Hypopharyngeal Neoplasms - therapy ; Hypopharynx ; Kaplan-Meier Estimate ; laryngectomy ; Male ; Middle Aged ; pharyngectomy ; Propensity Score ; Proportional Hazards Models ; Radiotherapy, Adjuvant - mortality ; Retrospective Studies ; SEER Program ; Squamous cell carcinoma ; Squamous Cell Carcinoma of Head and Neck - mortality ; Squamous Cell Carcinoma of Head and Neck - therapy ; squamous cell carcinoma of the head and neck ; Surgery ; Surveillance ; Survival Rate ; Throat cancer ; Treatment Outcome</subject><ispartof>The Laryngoscope, 2020-11, Vol.130 (11), p.2611-2621</ispartof><rights>2019 The American Laryngological, Rhinological and Otological Society, Inc.</rights><rights>2020 The American Laryngological, Rhinological and Otological Society, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4482-9b95c3a7a9cc768b76796c94dafd447298625d22b6f6be1428aad53b88cc8e213</citedby><cites>FETCH-LOGICAL-c4482-9b95c3a7a9cc768b76796c94dafd447298625d22b6f6be1428aad53b88cc8e213</cites><orcidid>0000-0001-9389-2332 ; 0000-0002-0243-3833</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Flary.28452$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Flary.28452$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31821572$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hochfelder, Colleen G.</creatorcontrib><creatorcontrib>McGinn, Aileen P.</creatorcontrib><creatorcontrib>Mehta, Vikas</creatorcontrib><creatorcontrib>Castellucci, Enrico</creatorcontrib><creatorcontrib>Kabarriti, Rafi</creatorcontrib><creatorcontrib>Ow, Thomas J.</creatorcontrib><title>Treatment sequence and survival in locoregionally advanced hypopharyngeal cancer: A surveillance, epidemiology, and end results–based study</title><title>The Laryngoscope</title><addtitle>Laryngoscope</addtitle><description>Objectives/Hypothesis
The objective of this study was to examine the association between modality of primary treatment and survival among patients with locoregionally advanced hypopharyngeal cancer.
Study Design
Retrospective cohort.
Methods
There were 2,328 adult patients diagnosed with stage III or IV, M0, hypopharyngeal squamous cell carcinoma identified within the Surveillance, Epidemiology and End Results (SEER) registry (years 2004–2015). Patients who received primary chemoradiation (CRT) were compared to those who received surgery with either adjuvant radiation therapy (S + RT), or surgery with adjuvant CRT (S + CRT). The latter primary surgery group (S + Adj) was also analyzed collectively. Overall survival (OS) and disease‐specific survival (DSS) were assessed using Kaplan‐Meier analyses and Cox regression models using a propensity score to adjust for factors associated with treatment allocation.
Results
Median survival was 20 months (interquartile range [IQR] = 10–45) with CRT and 25 months (IQR = 10–47) with S + Adj (P < .001). S + Adj had higher‐grade cancers and more advanced T staging (P < .001). S + CRT was associated with longer OS (hazard ratio [HR] = 0.70, 95% confidence interval [CI]: 0.59‐0.84) and DSS (HR = 0.66, 95% CI: 0.54‐0.82) after adjusting for age, gender, race, subsite, grade, and stage. S + RT was associated with longer DSS than CRT (HR = 0.75, 95% CI: 0.57‐0.99) but not OS (HR = 0.82, 95% CI: 0.66‐1.04). S + Adj was associated with longer DSS in T1/T2 disease (P = .04) and T4 disease (P = .0003), but did not reach significance among patients with T3 disease (P = .06).
Conclusions
Among patients with advanced hypopharyngeal cancer reported in the SEER database, treatment with S + Adj was associated with longer DSS and OS compared to those treated with primary CRT.
Level of Evidence
2b Laryngoscope, 130:2611–2621, 2020</description><subject>Aged</subject><subject>Cancer therapies</subject><subject>Chemoradiotherapy - mortality</subject><subject>Chemoradiotherapy, Adjuvant - mortality</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Head & neck cancer</subject><subject>Humans</subject><subject>hypopharyngeal neoplasms</subject><subject>Hypopharyngeal Neoplasms - mortality</subject><subject>Hypopharyngeal Neoplasms - therapy</subject><subject>Hypopharynx</subject><subject>Kaplan-Meier Estimate</subject><subject>laryngectomy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>pharyngectomy</subject><subject>Propensity Score</subject><subject>Proportional Hazards Models</subject><subject>Radiotherapy, Adjuvant - mortality</subject><subject>Retrospective Studies</subject><subject>SEER Program</subject><subject>Squamous cell carcinoma</subject><subject>Squamous Cell Carcinoma of Head and Neck - mortality</subject><subject>Squamous Cell Carcinoma of Head and Neck - therapy</subject><subject>squamous cell carcinoma of the head and neck</subject><subject>Surgery</subject><subject>Surveillance</subject><subject>Survival Rate</subject><subject>Throat cancer</subject><subject>Treatment Outcome</subject><issn>0023-852X</issn><issn>1531-4995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kd1qFDEUx4NY7Fq98QFkwBuRTp18TCbjhbAUa4UFQSroVcgkZ3dTMpNpMrMyd76AV75hn8TMbi3qhRfhwDm__M_HH6FnuDjDRUFeOxWmMyJYSR6gBS4pzlldlw_RIhVpLkry5Rg9jvG6KHBFy-IROqZYEFxWZIF-XAVQQwvdkEW4GaHTkKnOZHEMO7tTLrNd5rz2ATbWd8q5KVNmpxJmsu3U-36bmncbSKSes-FNttx_BuvcnDjNoLcGWuud30yne3FIL0Ac3RBvv_9sVExicRjN9AQdrZWL8PQunqDPF--uzi_z1cf3H86Xq1wzJkheN3WpqapUrXXFRVPxqua6ZkatDWMVqQUnpSGk4WveAGZEKGVK2gihtQCC6Ql6e9Dtx6YFo9P6QTnZB9umdaRXVv5d6exWbvxOprMxwWkSeHknEHy6Whxka6OGeWXwY5SEElZjTtnc68U_6LUfQzplopJltOAFJ4l6daB08DEGWN8Pgws5uyxnl-Xe5QQ__3P8e_S3rQnAB-CbdTD9R0qulp--HkR_AZrVt4k</recordid><startdate>202011</startdate><enddate>202011</enddate><creator>Hochfelder, Colleen G.</creator><creator>McGinn, Aileen P.</creator><creator>Mehta, Vikas</creator><creator>Castellucci, Enrico</creator><creator>Kabarriti, Rafi</creator><creator>Ow, Thomas J.</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-9389-2332</orcidid><orcidid>https://orcid.org/0000-0002-0243-3833</orcidid></search><sort><creationdate>202011</creationdate><title>Treatment sequence and survival in locoregionally advanced hypopharyngeal cancer: A surveillance, epidemiology, and end results–based study</title><author>Hochfelder, Colleen G. ; McGinn, Aileen P. ; Mehta, Vikas ; Castellucci, Enrico ; Kabarriti, Rafi ; Ow, Thomas J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4482-9b95c3a7a9cc768b76796c94dafd447298625d22b6f6be1428aad53b88cc8e213</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Cancer therapies</topic><topic>Chemoradiotherapy - mortality</topic><topic>Chemoradiotherapy, Adjuvant - mortality</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Head & neck cancer</topic><topic>Humans</topic><topic>hypopharyngeal neoplasms</topic><topic>Hypopharyngeal Neoplasms - mortality</topic><topic>Hypopharyngeal Neoplasms - therapy</topic><topic>Hypopharynx</topic><topic>Kaplan-Meier Estimate</topic><topic>laryngectomy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>pharyngectomy</topic><topic>Propensity Score</topic><topic>Proportional Hazards Models</topic><topic>Radiotherapy, Adjuvant - mortality</topic><topic>Retrospective Studies</topic><topic>SEER Program</topic><topic>Squamous cell carcinoma</topic><topic>Squamous Cell Carcinoma of Head and Neck - mortality</topic><topic>Squamous Cell Carcinoma of Head and Neck - therapy</topic><topic>squamous cell carcinoma of the head and neck</topic><topic>Surgery</topic><topic>Surveillance</topic><topic>Survival Rate</topic><topic>Throat cancer</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hochfelder, Colleen G.</creatorcontrib><creatorcontrib>McGinn, Aileen P.</creatorcontrib><creatorcontrib>Mehta, Vikas</creatorcontrib><creatorcontrib>Castellucci, Enrico</creatorcontrib><creatorcontrib>Kabarriti, Rafi</creatorcontrib><creatorcontrib>Ow, Thomas J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The Laryngoscope</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hochfelder, Colleen G.</au><au>McGinn, Aileen P.</au><au>Mehta, Vikas</au><au>Castellucci, Enrico</au><au>Kabarriti, Rafi</au><au>Ow, Thomas J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment sequence and survival in locoregionally advanced hypopharyngeal cancer: A surveillance, epidemiology, and end results–based study</atitle><jtitle>The Laryngoscope</jtitle><addtitle>Laryngoscope</addtitle><date>2020-11</date><risdate>2020</risdate><volume>130</volume><issue>11</issue><spage>2611</spage><epage>2621</epage><pages>2611-2621</pages><issn>0023-852X</issn><eissn>1531-4995</eissn><abstract>Objectives/Hypothesis
The objective of this study was to examine the association between modality of primary treatment and survival among patients with locoregionally advanced hypopharyngeal cancer.
Study Design
Retrospective cohort.
Methods
There were 2,328 adult patients diagnosed with stage III or IV, M0, hypopharyngeal squamous cell carcinoma identified within the Surveillance, Epidemiology and End Results (SEER) registry (years 2004–2015). Patients who received primary chemoradiation (CRT) were compared to those who received surgery with either adjuvant radiation therapy (S + RT), or surgery with adjuvant CRT (S + CRT). The latter primary surgery group (S + Adj) was also analyzed collectively. Overall survival (OS) and disease‐specific survival (DSS) were assessed using Kaplan‐Meier analyses and Cox regression models using a propensity score to adjust for factors associated with treatment allocation.
Results
Median survival was 20 months (interquartile range [IQR] = 10–45) with CRT and 25 months (IQR = 10–47) with S + Adj (P < .001). S + Adj had higher‐grade cancers and more advanced T staging (P < .001). S + CRT was associated with longer OS (hazard ratio [HR] = 0.70, 95% confidence interval [CI]: 0.59‐0.84) and DSS (HR = 0.66, 95% CI: 0.54‐0.82) after adjusting for age, gender, race, subsite, grade, and stage. S + RT was associated with longer DSS than CRT (HR = 0.75, 95% CI: 0.57‐0.99) but not OS (HR = 0.82, 95% CI: 0.66‐1.04). S + Adj was associated with longer DSS in T1/T2 disease (P = .04) and T4 disease (P = .0003), but did not reach significance among patients with T3 disease (P = .06).
Conclusions
Among patients with advanced hypopharyngeal cancer reported in the SEER database, treatment with S + Adj was associated with longer DSS and OS compared to those treated with primary CRT.
Level of Evidence
2b Laryngoscope, 130:2611–2621, 2020</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>31821572</pmid><doi>10.1002/lary.28452</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-9389-2332</orcidid><orcidid>https://orcid.org/0000-0002-0243-3833</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Aged Cancer therapies Chemoradiotherapy - mortality Chemoradiotherapy, Adjuvant - mortality Epidemiology Female Head & neck cancer Humans hypopharyngeal neoplasms Hypopharyngeal Neoplasms - mortality Hypopharyngeal Neoplasms - therapy Hypopharynx Kaplan-Meier Estimate laryngectomy Male Middle Aged pharyngectomy Propensity Score Proportional Hazards Models Radiotherapy, Adjuvant - mortality Retrospective Studies SEER Program Squamous cell carcinoma Squamous Cell Carcinoma of Head and Neck - mortality Squamous Cell Carcinoma of Head and Neck - therapy squamous cell carcinoma of the head and neck Surgery Surveillance Survival Rate Throat cancer Treatment Outcome |
| title | Treatment sequence and survival in locoregionally advanced hypopharyngeal cancer: A surveillance, epidemiology, and end results–based study |
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