title: Disease control and clinicopathological prognostic factors of total pharyngolaryngectomy for hypopharyngeal cancer: a single-center study.
abstract: BACKGROUND
  Total pharyngolaryngectomy (TPL) is a conventional and standard surgical method for locoregional control of advanced hypopharyngeal cancer (HPC). This study aimed to define the clinicopathological prognostic factors of TPL by evaluating our surgical experience of TPL in the treatment of HPCs.
  
  
  METHODS
  We retrospectively reviewed the clinical charts of patients with HPC who were treated between 1995 and 2011 at the University of Tokyo Hospital and enrolled 119 patients who underwent TPL as an initial curative treatment.
  
  
  RESULTS
  The mean follow-up period was 46 months (range, 2-164 months). The 5-year overall survival (OS), disease-specific survival (DSS), locoregional control rates, and relapse-free survival for all patients were 44, 53, 76, and 50 %, respectively. In multivariate analysis, the number of ≥4 metastatic lymph nodes (LNs) was a significant poor prognostic factor for both OS and DSS (p = 0.03 and p = 0.01). Patients with moderate to severe comorbidities had poor prognoses for OS (p = 0.002). In addition, patients with the number of ≥4 metastatic LNs had a higher incidence of distant metastases (p < 0.0001).
  
  
  CONCLUSIONS
  The locoregional control rate following TPL was acceptable and the number of metastatic LNs was associated with the incidence of distant metastases.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan, goomura@msn.com.
authors.forename: Go
authors.initials: G
authors.lastname: Omura
authors.forename: Mizuo
authors.initials: M
authors.lastname: Ando
authors.forename: Yuki
authors.initials: Y
authors.lastname: Saito
authors.forename: Kenya
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Yamasoba
authors.forename: Takahiro
authors.initials: T
authors.lastname: Asakage
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000556:secondary* / Q000601:surgery*; D015897:Comorbidity; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology* / Q000601:surgery*; D007825:Laryngectomy / Q000009:adverse effects; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D010611:Pharyngectomy / Q000009:adverse effects; D012189:Retrospective Studies; D015996:Survival Rate