title: Contemporary therapeutic management of locally advanced hypopharyngeal cancer: oncologic and functional outcomes - a report on 100 cases.
abstract: CONCLUSIONS
  A significant proportion of patients with locally advanced hypopharyngeal cancer could not be managed by larynx-sparing therapy. T4 stage is one of the main predictive factors of oncologic and functional outcomes.
  
  
  OBJECTIVE
  To analyze the therapeutic management of patients with locally advanced hypopharyngeal cancer in clinical practice and to report oncologic and functional outcomes.
  
  
  METHODS
  This was a retrospective study of all patients treated for a locally advanced hypopharyngeal squamous cell carcinoma between 2001 and 2012 at our institution.
  
  
  RESULTS
  A total of 100 patients were included in this study. Induction chemotherapy (CT) followed by radiotherapy (RT) ± CT, primary RT + CT, and primary total pharyngolaryngectomy (TPL) comprised the initial therapeutic management for 54, 24, and 20 patients, respectively. Two patients received only supportive care. Overall survival (OS) and cause-specific survival (SS) were 50% and 60% at 3 years, respectively. In the group of patients referred for induction CT, the 3-year OS and SS were 58% and 70%, respectively. In multivariate analysis, T stage (p = 0.05) and ASA score (p = 0.02) were significant predictive factors of OS. T4 tumor stage had a pejorative impact on swallowing function after therapy (p = 0.006). The rate of patients alive, disease-free, and with a functional larynx at 2 years was 23%.
authors.affiliation: Institut Universitaire de la Face et du Cou , Nice.
authors.forename: Clair
authors.initials: C
authors.lastname: Vandersteen
authors.forename: Karen
authors.initials: K
authors.lastname: Benezery
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Chamorey
authors.forename: Marc
authors.initials: M
authors.lastname: Ettaiche
authors.forename: Olivier
authors.initials: O
authors.lastname: Dassonville
authors.forename: Gilles
authors.initials: G
authors.lastname: Poissonnet
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Riss
authors.forename: Cédric Sandy
authors.initials: CS
authors.lastname: Pierre
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Hannoun-Lévi
authors.forename: Marie-Eve
authors.initials: ME
authors.lastname: Chand
authors.forename: Axel
authors.initials: A
authors.lastname: Leyssale
authors.forename: Frédéric
authors.initials: F
authors.lastname: Peyrade
authors.forename: Anne
authors.initials: A
authors.lastname: Sudaka
authors.forename: Juliette
authors.initials: J
authors.lastname: Haudebourg
authors.forename: François
authors.initials: F
authors.lastname: Demard
authors.forename: José
authors.initials: J
authors.lastname: Santini
authors.forename: Alexandre
authors.initials: A
authors.lastname: Bozec
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000628:therapy*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality / Q000628:therapy*; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D010611:Pharyngectomy; D012189:Retrospective Studies
keywords: Hypopharynx; induction chemotherapy; prognosis; survival; total pharyngolaryngectomy; treatment