Cliinical Analysis Of 83 Hypopha Yrngeal Squamous Cell Carcinomas

Objective:To investigate the efficacy of different treatments and survival analysis.Methods:Eighty-three hypopharyngeal squmous cell carcinoma patients who accepted treatments in the Department of Head and Neck of Affiliated Tumer Hospital of GuangXi Medical University from January 1999 to October 2007 were analyzed retrospectively,of which 59 were originated from pyriform sinus,17 from posterior pharyngeal wal1 and 7 from postcricoid. Histologically,12 were well differentiated,28 were moderately differentiated,and 43 were poorly differentiated. 10 stageⅠcases,21 stageⅡcases,12 stageⅢcases,and 40 stageⅣcases,according to UICC 2002.Of the 83 patients,32 were treated with surgery and radiotherapy(S+R group),27 were treated with surgery and radiotherapy and chemotherapy(S+R+C group), 24 were treated with surgery and chemotherapy(S+C group).Life Tables was used to examine the overall survival curve. Kaplan-Meier analysis was used to examine survival.Log-rank test was used to compare the differences in the efficacy of treatment among the three groups.Multi-variate analysis was performed using the Cox regression model.Chi-squre test and exact probabilities were used in count data,α=P,while P﹤0.05,it had statistical significance.Results:1.The overall 3-year and 5-year survival rates were 53.0% and 35.8%,respectively,three groups had different survival rates(P=0.001).Their 3-year survival rates were 54.3%,65.4% and 32.1%,respectively, 5-year survival rates were 37.3%,49.0% and 4.6%,respectively.2.Treatment modality , cervical lymph node metastasis, T-stage,N-stage, clinical stage, and histological grade were associated with prognosis.Multivariate analysis revealed that treatment modality,T-stage,N-stage and histological grade were independent prognostic factors.Conclusion:1.S+R+C group has the highest survival rate, Surgery combined with radiotherapy is currently the best treatment. S+R group and S+R+C group have more higer survival rate than S+C group. S+R+C group is not higher than S+R group in survival rate.2. Treatment modality,T-stage,N-stage and histological grade were possible independent prognostic factors, cervical lymph node metastasis and clinical stage may not be the independent prognostic factors. 3.We should decrease relapse rate,metastasis rate and improve the quality of life of patients in further research.