Chu Pen-Yuan, Li Wing-Yin, Chang Shyue-Yih
Department of Otolaryngology, Taipei Veterans General Hospital and National Yang-Ming University, 201, Sec 2, Shih-Pai Road, Taipei 112, Taiwan.
Ann Otol Rhinol Laryngol. 2008 Mar;117(3):201-6. doi: 10.1177/000348940811700307.
Hypopharyngeal squamous cell carcinoma (HPSCC) usually presents at an advanced stage. Although chemoradiotherapy has become more popular in treating HPSCC in recent years, surgery with postoperative adjuvant therapy still plays an important role. The purpose of this study was to identify the clinicopathologic factors that predict survival in patients with HPSCC who underwent surgical treatment.
Between 1986 and 1995, 94 previously untreated HPSCC patients who underwent surgery with or without postoperative radiotherapy were enrolled. The surgical specimens were reexamined by a single pathologist. The clinicopathologic parameters and prognostic data were analyzed.
With a median follow-up of 50 months, the 5-year overall survival (OS), disease-specific survival (DSS), and relapse-free survival (RFS) were 47%, 60%, and 58%, respectively. Thirty-seven patients (39%) had tumor recurrence. The level of lymph node metastasis was an independent factor in OS, DSS, and RFS. Neck biopsy before surgery, tumor involvement of more than 1 subsite, and extracapsular spread were independent factors in DSS, as was lymphovascular permeation in RFS.
The level of cervical lymph node metastasis is the only independent prognostic factor in OS, DSS, and RFS. The addition of postoperative chemoradiotherapy may benefit high-risk cases.
下咽鳞状细胞癌（HPSCC）通常在晚期出现。尽管近年来放化疗在HPSCC治疗中变得更为普遍，但手术联合术后辅助治疗仍发挥着重要作用。本研究的目的是确定接受手术治疗的HPSCC患者生存的临床病理预测因素。
1986年至1995年间，94例未经治疗的HPSCC患者接受了手术，部分患者接受了术后放疗。手术标本由一名病理学家重新检查。分析临床病理参数和预后数据。
中位随访50个月，5年总生存率（OS）、疾病特异性生存率（DSS）和无复发生存率（RFS）分别为47%、60%和58%。37例患者（39%）出现肿瘤复发。淋巴结转移水平是OS、DSS和RFS的独立因素。术前颈部活检、肿瘤累及超过1个亚部位以及包膜外扩散是DSS的独立因素，而RFS的独立因素是淋巴管浸润。
颈部淋巴结转移水平是OS、DSS和RFS的唯一独立预后因素。术后放化疗可能使高危病例受益。
