title: Treatment trends and survival effects of chemotherapy for hypopharyngeal cancer: Analysis of the National Cancer Data Base.
abstract: The current study was performed to characterize trends and survival outcomes for chemotherapy in the definitive and adjuvant treatment of hypopharyngeal cancer in the United States.
  
  
  
  A total of 16,248 adult patients diagnosed with primary hypopharyngeal cancer without distant metastases between 1998 and 2011 were identified in the National Cancer Data Base. The association between treatment modality and overall survival was analyzed using Kaplan-Meier survival curves and 5-year survival rates. A multivariate Cox regression analysis was performed on a subset of 3357 cases to determine the treatment modalities that predict improved survival when controlling for demographic and clinical factors.
  
  
  
  There was a significant increase in the use of chemotherapy with radiotherapy both as definitive treatment (P<.001) and as adjuvant chemoradiotherapy with surgery (P=.001). This was accompanied by a decrease in total laryngectomy/pharyngectomy rates (P<.001). Chemoradiotherapy was associated with improved 5-year survival compared with radiotherapy alone in the definitive setting (31.8% vs 25.2%; log rank P<.001). Similarly, in multivariateanalysis, definitive radiotherapy was found to be associated with compromised survival compared with definitive chemoradiotherapy (hazard ratio, 1.51; P<.001).
  
  
  
  Survival analysis revealed that overall 5-year survival rates were higher for chemoradiotherapy compared with radiotherapy alone in the definitive setting, but were comparable between surgery with chemoradiotherapy and surgery with radiotherapy. Cancer 2016;122:1853-60. © 2016 American Cancer Society.
authors.affiliation: Division of Otolaryngology, Department of Surgery, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Phoebe
authors.initials: P
authors.lastname: Kuo
authors.affiliation: Division of Endocrine Surgery, Department of Surgery, Duke University School of Medicine, Durham, North Carolina.|Duke Clinical Research Institute, Durham, North Carolina.|Duke Cancer Institute, Durham, North Carolina.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Sosa
authors.affiliation: Yale Cancer Center, New Haven, Connecticut.|Department of Medicine, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Burtness
authors.affiliation: Yale Cancer Center, New Haven, Connecticut.|Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Zain A
authors.initials: ZA
authors.lastname: Husain
authors.affiliation: Division of Otolaryngology, Department of Surgery, Yale School of Medicine, New Haven, Connecticut.|Yale Cancer Center, New Haven, Connecticut.
authors.forename: Saral
authors.initials: S
authors.lastname: Mehra
authors.affiliation: Division of Endocrine Surgery, Department of Surgery, Duke University School of Medicine, Durham, North Carolina.
authors.forename: Sanziana A
authors.initials: SA
authors.lastname: Roman
authors.affiliation: Division of Otolaryngology, Department of Surgery, Yale School of Medicine, New Haven, Connecticut.|Yale Cancer Center, New Haven, Connecticut.|Department of Pathology, Yale School of Medicine, New Haven, Connecticut.
authors.forename: Wendell G
authors.initials: WG
authors.lastname: Yarbrough
authors.affiliation: Division of Otolaryngology, Department of Surgery, Yale School of Medicine, New Haven, Connecticut.|Yale Cancer Center, New Haven, Connecticut.
authors.forename: Benjamin L
authors.initials: BL
authors.lastname: Judson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D059186:Chemoradiotherapy, Adjuvant / Q000706:statistics & numerical data / Q000639:trends; D016208:Databases, Factual; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000188:drug therapy* / Q000401:mortality* / Q000532:radiotherapy / Q000601:surgery; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant / Q000706:statistics & numerical data / Q000639:trends; D000077195:Squamous Cell Carcinoma of Head and Neck; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: chemotherapy; head and neck cancer; hypopharyngeal cancer; hypopharynx; survival