Wahlberg P C, Andersson K E, Biörklund A T, Möller T R
Department of Otorhinolaryngology, Head & Neck Surgery, Lund, Sweden.
Head Neck. 1998 Dec;20(8):714-9. doi: 10.1002/(sici)1097-0347(199812)20:8<714::aid-hed9>3.0.co;2-2.
The aim of the study was to analyze whether there were any changes in incidence and prognosis of hypopharyngeal carcinomas diagnosed between 1960 and 1989 in Sweden.
Data of primary hypopharyngeal malignant tumors reported to the Swedish Cancer Registry were collected. The total number of cases was 2012, 1396 men and 616 women, and the end of follow-up was December 31, 1992.
For women, a significant decrease in the age-standardized incidence (ASI) was seen, with an average decrease of 2% per year (p < .001), which was most evident in rural counties. The male patients, on the contrary, showed a significant increase of about 1.5% per year (p < .001); the metropolitan areas had an ASI about twice that of more-rural areas. The 2- and 5-year overall survival was poor, only 25% and 13%, respectively. For women aged <60 years, no difference in survival between the different 10-year periods was seen, but survival for men of corresponding ages improved significantly (p < .01) during the last decade, to reach a survival similar to that in women. For patients aged > or = 60 years, no difference in survival between the different periods or between sexes was seen.
The increased incidence in hypopharyngeal cancer in men is similar to that observed for oral and pharyngeal cancer in many European countries during this period. The disappearance of Plummer-Vinson syndrome may explain the decreased incidence among women. The treatment results in hypopharyngeal cancer are still very poor, and improvements of the therapeutic methods are needed.
本研究旨在分析1960年至1989年期间在瑞典诊断出的下咽癌的发病率和预后是否有任何变化。
收集了向瑞典癌症登记处报告的原发性下咽恶性肿瘤的数据。病例总数为2012例，其中男性1396例，女性616例，随访截止于1992年12月31日。
对于女性，年龄标准化发病率（ASI）显著下降，平均每年下降2%（p <.001），这在农村县最为明显。相反，男性患者每年显著增加约1.5%（p <.001）；大都市区的ASI约为农村地区的两倍。2年和5年总生存率较低，分别仅为25%和13%。对于年龄<60岁的女性，不同10年期间的生存率没有差异，但在过去十年中，相应年龄段男性的生存率显著提高（p <.01），达到与女性相似的生存率。对于年龄≥60岁的患者，不同时期或性别之间的生存率没有差异。
男性下咽癌发病率的增加与同期许多欧洲国家口腔和咽癌的情况相似。普卢默-文森综合征的消失可能解释了女性发病率的下降。下咽癌的治疗结果仍然很差，需要改进治疗方法。
