title: The effectiveness of chemoradiation therapy and salvage surgery for hypopharyngeal squamous cell carcinoma.
abstract: OBJECTIVE
  The objective of this study was to evaluate the results of salvage surgery after definitive chemoradiation for hypopharyngeal squamous cell carcinoma.
  
  
  METHODS
  This was a retrospective cohort study. Of the 79 patients with previously untreated hypopharyngeal squamous cell carcinoma who received definitive chemoradiation from January 2004 to January 2009, 24 who had recurrence and underwent salvage surgery at the National Cancer Center Hospital East, Chiba, Japan, were enrolled in this study.
  
  
  RESULTS
  Of the 24 patients who underwent salvage surgery with curative intent, 13 had an isolated local failure, eight had an isolated neck failure and three had combined local and regional failure. Postoperative surgical complications were observed in eight (33.3%) patients. Of the 24 patients undergoing salvage surgery, 12 (50%) had recurrence. In 11 of these patients, death ensued from salvage failure, defined as the presence of any recurrence after salvage treatment. The causes of cancer-specific death ensuing from salvage failure were regional recurrence of the tumor (n = 6) (one of whom had concurrent distant metastases) and distant metastases alone (n = 5). No local recurrence after salvage surgery was observed in our group of patients. The disease-free and overall 24-month survival rates were 49.0 and 50.0%, respectively. Those patients who initially presented with unresectable disease had lower overall survival compared with those who initially presented with resectable disease (P = 0.0003).
  
  
  CONCLUSIONS
  The oncologic outcomes were acceptable in those patients in whom salvage surgery was carried out. Those who initially presented with unresectable disease had a poor prognosis.
authors.affiliation: *Head and Neck Surgery Division, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba 277-8577, Japan. rhayashi@east.ncc.go.jp.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Suzuki
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Hayashi
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Ebihara
authors.forename: Masakazu
authors.initials: M
authors.lastname: Miyazaki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shinozaki
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daiko
authors.forename: Minoru
authors.initials: M
authors.lastname: Sakuraba
authors.forename: Sadamoto
authors.initials: S
authors.lastname: Zenda
authors.forename: Makoto
authors.initials: M
authors.lastname: Tahara
authors.forename: Satoshi
authors.initials: S
authors.lastname: Fujii
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D059186:Chemoradiotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D000077143:Docetaxel; D019583:Dose Fractionation, Radiation; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006258:Head and Neck Neoplasms / Q000628:therapy; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D060828:Induction Chemotherapy; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods; D000077195:Squamous Cell Carcinoma of Head and Neck; D043823:Taxoids / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D002945:Cisplatin; D005472:Fluorouracil
keywords: chemoradiation therapy; hypopharyngeal squamous cell carcinoma; salvage surgery