| ObjectiveTo investigate the related factors affecting the prognosis of patients with hypopharyngeal cancer,and to analyze the efficacy of different treatment methods,so as to provide new ideas for the treatment of hypopharyngeal cancer.MethodsA retrospective review of the patients'database from otolaryngology department of Shandong university Qilu hospital between January 2006 to December 2017 was conducted.A total of 771 patients who were diagnosed as hypopharyngeal squamous cell carcinoma and treated with surgery were enrolled in the study Student's t test was used for measurement data,chi-square test was used for enumeration data,and rank sum test was used for grade data.Life Table was used to calculate the total survival rate of patients in our study.Patients were subgrouped according to different clinical factors.Patients'survival rates were calculated by Kaplan-Meier analysis,and Cox regression model were used for multi-variate analysis.P values<0.05 were considered to be of significance.Results1.A total of 771 patients with hypopharyngeal cancer were enrolled in this study,including 727 males and 44 females,with a male to female ratio of 16.5:1.The patients were between 33 and 85 years old,with a median age of 59±9.In the study,there were 598 cases of pyriform sinus carcinoma,128 cases of posterior hypopharyngeal wall carcinoma,and 45 cases of postcricoid carcinoma according to the primary tumor sites.According to the degree of tumor pathological differentiation,101 cases were highly differentiated,329 cases were moderately differentiated,and 341 cases were poorly differentiated.According to TNM grading,there were 35 cases staged in T1 stage,275 in T2,371 in T3,90 in T4,218 in NO,137 in Nl,408 in N2,and 8 in N3.All 771 cases were stage MO.According to the clinical stages of tumor,17 cases were in stage I,82 cases in stage II,225 cases in stage ?,and 447 cases in stage ?.2.There were statistically significant differences in clinical stages and N stages according to genders and a history of alcohol and tobacco use.Men with drinking and smoking tended to have more advanced clinical stages and N stages.There were statistical differences in gender,drinking,smoking,clinical stage,N stage,and the degree of pathological differentiation among different primary lesions.Compared with the posterior hypopharyngeal wall carcinoma,the proportion of males with drinking and smoking in pyriform sinus carcinoma was significantly higher.And pyriform sinus carcinoma tends to be of an advanced clinical stage,N stage,or lower degree of differentiation than posterior hypopharyngeal wall carcinoma.Postcricoid carcinoma tends to have more advanced N stage or a lower degree of differentiation than posterior hypopharyngeal carcinoma.3.We used the Life Table method to calculate the total survival rate of patients in this study.The 1-year,3-year and 5-year survival rates were 82%,55%and 42%,respectively,and the median survival time was 42 months.Through statistical analysis,we found that smoking,T stage,N stage,clinical stage and retain laryngeal function were all factors related with the prognosis of hypopharyngeal cancer,while gender,age,drinking,primary lesion location,degree of pathological differentiation,therapy and postoperative complications had no statistical significance on the survival rate of hypopharyngeal cancer.Cox regression analysis showed that smoking and clinical stage were independent factors affecting the prognosis of hypopharyngeal cancer.Conclusion1?Hypopharyngeal cancer is a rare malignant tumor in the head and neck with poor prognosis because the disease progression is insidious,invasive,and prone to have submucosal infiltration and diffusion.Moreover lymph nodes and distant metastasis are easy to occur in the early stage.2?Surgical comprehensive therapy is the most effective method for the treatment of hypopharyngeal cancer.The principles and indications of surgical treatment should be fully considered,including the scope of tumor resection,cervical lymph node dissection,whether to retain the function of the larynx,and the repair of surgical defects.In addition,the occurrence of postoperative complications should be prevented.3?Smoking is not only one of the causes of hypopharyngeal carcinoma,but also an independent risk factor affecting its prognosis.So it is strongly recommended that patients should quit smoking.Though drinking does not affect the prognosis of patients,it is an important cause of hypopharyngeal carcinoma,so patients should also be advised to quit drinking.4?Clinical stage is the other independent factor related with the prognosis of hypopharyngeal cancer,so early detection and early treatment should be done. |
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