| Objective To analyze the risk factors of the overall survival and progression-free survival of patients with hypopharyngeal carcinoma,so as to provide references for clinical treatment.Methods A retrospective review of the Second Affiliated Hospital of Jilin University patients' database between January 1,2008 and March 1,2016 was conducted and 97 complete cases which confirmed hypopharyngeal squamous cell carcinoma pathologically.These patients were divided into four groups according to treatment methods: 29 patients in the surgery alone group(S),32 cases in the surgery & radiotherapy group(SR)and 8 cases in the radiotherapy alone group(R),and 28 cases in the concurrent radiochemotherapy group(CCR).The clinical characteristics of the patients including the geners,ages,primary tumor sites,TNM stages,clinical stages,treatments and pathologic differentiation were collected.The Kaplan-Meier method was used for the analysis of the overall survival(OS)and the progression-free survival(PFS).Multivariate analysis to find independent risk factors was accomplished by Cox regression model and presented as survival curves.When p<0.05,it was considered statistically significant.Results 1.Clinical features: There are 97 patients who were diagnosed of hypopharyngeal cancer in this research,93 males and 4 females.The average age was(57.1 ± 7.9)years old.Most of them don't deny the history of smoking and drinking which accounting for 85.6% and 89.7% of the total amount respectively.The number of the primary tumor sites in pyriform sinus was 76(78.4%),13(13.4%)in posterior pharyngeal wall and 8(8.2%)in the postcricoid region.As for TNM stages: 51 cases(52.6%)were in T1-T2stages and 46 cases(47.4%)were in T3-T4 stages.20 cases(20.6%)were in N0 stage,41 cases(42.3%)were in the N1 stage and 36 cases(37.1%)were in the N2-N3 stage.Clinical stages: the group of?-? stages included 11 cases(11.3%),86 cases(88.7%)of staging ?-? were collected.Pathological differentiation: 4 cases(4.1%)were situ carcinoma,well-differentiated squamous cell carcinoma was in 20 cases(20.6%),the moderately was in 65(67.0%)cases and the poorly was in 8(8.3%)cases.2.Survival analysis: The overall survival rates(OSR)were 91.8%,55.6%,39.9% in 1 year,3 years and 5 years,while the progression-free survival rates(PFSR)were 73.6%,25.4% and 3.2% respectively.The treatment was the risk factor in OS(p = 0.002)and PFS(p = 0.003)but not an independent risk factor in neither.The independent risk factors for OS was N stages(p = 0.001),while for PFS were N stages(p = 0.000)and age groups(p = 0.013).Conclusion 1.The hypopharyngeal cancer is an aggressive malignant tumor which is characterized by the low incidence,the occult progress,the complex operative process and the poor prognosis.2.About 50% of the patients were diagnosed in their ages of 51 to 60.The number of men was significantly more than that of women,and most patients had a long-term(> 20 years)smoking or/and drinking history.3.The survival time of cancer patients was significantly related to the metastasis of cervical lymph nodes.Because of not being an independent risk factor for the treatment,patients need to be carefully examined before making a plan of a therapy and to be analyzed comprehensively.4.For early-staged patients,the therapy can be effective through the surgery or the radiotherapy alone.In terms of advanced-staged patients,however,it is suggested that comprehensive treatment based on operation should be applied.The elder patients are not recommended to be over-treated. |
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