Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medical Center, NewYork-Presbyterian Hospital, New York, New York.
Biostatistics Facility, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania.
Head Neck. 2019 Jul;41(7):2167-2173. doi: 10.1002/hed.25687. Epub 2019 Feb 19.
Organ preservation protocols have increasingly been applied for the treatment of head and neck cancers, including hypopharyngeal squamous cell carcinoma (HSCC). We sought to evaluate whether patients treated with primary surgery followed by adjuvant therapy had survival benefit over patients treated with initial nonsurgical modalities.
We retrospectively reviewed patients with new diagnosis of HSCC at the University of Pittsburgh (1994-2014) treated with either primary total laryngectomy with pharyngectomy or organ preservation.
One hundred thirty-seven patients were identified. Surgical cases were more likely to be of advanced T stage. Initial surgery was more likely to be performed in the earlier years of the cohort. After adjusting for this imbalance using a propensity score, primary surgery was associated with improved survival compared with nonoperative therapy (P = 0.02).
Due to its survival advantage, primary surgery followed by adjuvant treatment should be considered as a viable treatment of HSCC.
器官保存方案已越来越多地应用于头颈部癌症的治疗，包括下咽鳞状细胞癌（HSCC）。我们试图评估与初始非手术方式治疗相比，接受初始手术加辅助治疗的患者是否具有生存优势。
我们回顾性分析了匹兹堡大学（1994-2014 年）新诊断为 HSCC 的患者，这些患者接受了全喉切除术伴咽切除术或器官保存治疗。
共确定了 137 例患者。手术病例更可能处于晚期 T 期。初始手术更可能在队列的早期进行。使用倾向评分校正这种不平衡后，与非手术治疗相比，原发手术与生存改善相关（P=0.02）。
由于生存优势，原发手术后辅助治疗应被视为 HSCC 的一种可行治疗方法。
