title: Preservation of laryngeal function improves outcomes of patients with hypopharyngeal carcinoma.
abstract: This study compares clinical characteristics and survival between patients with and without laryngeal function (LF) preservation during surgical treatment for hypopharyngeal carcinoma. We retrospectively reviewed 485 cases of hypopharyngeal carcinoma treated at a single institution for analysis. There were 337 cases with and 148 cases without LF preservation after surgery. Preservation of LF was complete in 237 patients and partial in 100 patients. There were significant statistical differences between the preservation group and the group without preservation in T-stage (P < 0.001), overall staging (P < 0.001), and tumor sites (P < 0.001) except the N-stage (P = 0.240). The patients with LF preservation had significantly better overall survival (log-rank, P = 0.005) and a lower risk of death than those without LF preservation (HR 0.62, 95% CI 0.43-0.97), after multivariable adjustment. Treatment with surgery in combination with radiotherapy is still the favorable choice for patients with hypopharyngeal carcinoma. The maximal restoration of pharyngoesophageal continuity and function improves survival for patients whose tumors are excised completely for the preservation of LF and laryngeal and pharyngeal reconstruction.
authors.affiliation: Department of Otorhinolaryngology, Qilu Hospital, Shandong University, Key Laboratory of Otolaryngology, Ministry of Health, 107 West Wenhua Road, Jinan, Shandong, 250012, People's Republic of China.
authors.forename: Tong
authors.initials: T
authors.lastname: Jin
authors.forename: Xuezhong
authors.initials: X
authors.lastname: Li
authors.forename: Dapeng
authors.initials: D
authors.lastname: Lei
authors.forename: Dayu
authors.initials: D
authors.lastname: Liu
authors.forename: Qiuan
authors.initials: Q
authors.lastname: Yang
authors.forename: Guojun
authors.initials: G
authors.lastname: Li
authors.forename: Xinliang
authors.initials: X
authors.lastname: Pan
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D002681:China / Q000453:epidemiology; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D007825:Laryngectomy / Q000379:methods*; D007830:Larynx / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D059351:Organ Sparing Treatments / Q000379:methods*; D017063:Outcome Assessment, Health Care; D010614:Pharynx / Q000503:physiopathology / Q000601:surgery; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D016019:Survival Analysis