title: Can response to induction chemotherapy be a predictive marker for ultimate outcome in hypopharyngeal cancer?
abstract: OBJECTIVE
  Induction chemotherapy (ICT) may reduce rates of distant metastases and enhance organ preservation and survival rates in patients with hypopharyngeal cancer. The authors compared survival data in patients who underwent chemoradiotherapy or surgery after ICT and investigated whether response to ICT is a predictive marker for outcome in patients with hypopharyngeal cancer.
  
  
  METHODS
  Historical cohort study.
  
  
  METHODS
  Tertiary-care hospital.
  
  
  METHODS
  The authors enrolled 97 patients (89 men, 8 women; mean age 61.2 years; range, 29-80 years) with previously untreated hypopharyngeal cancer who underwent ICT between January 1997 and December 2006 at Asan Medical Center. Disease-free survival (DFS), overall survival (OS), and laryngectomy-free survival (LFS) were analyzed.
  
  
  RESULTS
  At a mean follow-up of 38.0 months, the 3-year DFS and OS for all patients were 48.3% and 49.2%, respectively. The 3-year LFS rate of patients who underwent nonsurgical therapy (n = 85) after ICT was 48.0%. Only response to ICT was associated with DFS (P = .047), OS (P = .003), and LFS (P = .009) in multivariate analysis. When the authors compared survival data in patients who underwent surgical and nonsurgical treatments after ICT, they found that there was no statistical difference in terms of the 3-year DFS in partial response (42.9% vs 50.5%, P = .77) and nonresponse groups (50.0% vs 0%, P = .43) between the 2 treatment types.
  
  
  CONCLUSIONS
  ICT permits assessment of tumor responsiveness and alters subsequent therapy accordingly. Response to ICT may be useful in the prediction of ultimate outcomes and organ conservation in patients with hypopharyngeal cancer.
authors: Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors: Myung Woul
authors: MW
authors: Han
authors: In Sun
authors: IS
authors: Ryu
authors: Sang-Wook
authors: SW
authors: Lee
authors: Sung-Bae
authors: SB
authors: Kim
authors: Jong-Lyel
authors: JL
authors: Roh
authors: Seung-Ho
authors: SH
authors: Choi
authors: Sang Yoon
authors: SY
authors: Kim
authors: Soon Yuhl
authors: SY
authors: Nam
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D060828:Induction Chemotherapy / Q000379:methods*; D007825:Laryngectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents