Prognostic significance of human papillomavirus status and treatment modality in hypopharyngeal cancer

Head Neck. 2021 Oct;43(10):3042-3052. doi: 10.1002/hed.26793. Epub 2021 Jun 24.

Abstract

Background: Management of hypopharynx cancer is often extrapolated from larynx cancer. This report analyses treatment patterns and survival limited to hypopharynx cancer using the National Cancer Database (NCDB).

Methods: There are 9314 patients diagnosed with hypopharynx cancer between 2004 and 2016. The association between treatment modality and survival was analyzed using Kaplan-Meier survival curves and multivariable Cox regression.

Results: Five-year overall survival ranged from 45% for stage I to 21% for stage IVB. Treatment modality did not influence survival in stage I/II. For stage III/IV, chemoradiation and surgery + adjuvant therapy were equivalent. Surgery yielded improved survival for T4 disease. Human papillomavirus (HPV)-positive tumors were present in 21% and were associated with improved hazard ratio of death (0.60, p = <0.0001).

Conclusions: Survival is superior for T4 hypopharynx cancer managed with surgery, while treatment modality does not impact outcomes for other T-stages. HPV-positive tumors are associated with improved survival regardless of treatment.

Keywords: chemoradiation; hypopharyngeal; hypopharynx; pyriform sinus; surgery.

MeSH terms

  • Alphapapillomavirus*
  • Carcinoma, Squamous Cell* / pathology
  • Head and Neck Neoplasms*
  • Humans
  • Hypopharyngeal Neoplasms* / pathology
  • Hypopharyngeal Neoplasms* / therapy
  • Neoplasm Staging
  • Papillomaviridae
  • Prognosis
  • Retrospective Studies