■不同治疗方式对下咽鳞状细胞癌(HPSCC)患者的预后影响尚不清楚。
■在2009年1月1日至2019年12月31日期间在华西医院或四川省肿瘤医院诊断和治疗的HPSCC患者纳入本回顾性研究,真实世界的研究。生存率使用Kaplan-Meier曲线表示,并使用对数秩检验进行比较。使用单变量和多变量Cox比例风险回归模型来确定总生存期(OS)的预测因子。对晚期HPSCC患者(III期和IV期以及T4类)进行亚组分析。
■共纳入527例HPSCC患者。接受SRC(手术,放射治疗[RT],和化疗)显示最佳OS(p<0.0001)。与单独的RT相比,单独手术(所有病例:风险比[HR]=0.39,p=0.0018;IV期病例:HR=0.38,p=0.0085)和基于手术的多模式治疗(SBMT;所有病例:HR=0.27,p<0.0001;IV期病例:HR=0.30,p=0.00025)均显示出预后益处,而SBMT也显示出优于放化疗的生存优先级(CRT;所有病例:HR=0.52,p<0.0001;IV期病例:HR=0.59,p=0.0033)。此外,仅接受手术的患者的OS与接受SBMT的患者相当(所有患者:p=0.13;IV期病例:p=0.34),而CRT的预后结果与单纯RT相似(所有患者:p=0.054;IV期病例:p=0.11)。
■在HPSCC患者的OS方面,单独手术与SBMT相当,优于RT/CRT。我们建议应鼓励手术治疗HPSCC,即使是晚期疾病患者。
UNASSIGNED: The prognostic effects of different treatment modalities on patients with hypopharyngeal squamous cell carcinoma (HPSCC) remain unclear.
UNASSIGNED: HPSCC patients diagnosed and treated at either West China Hospital or Sichuan Cancer Hospital between January 1, 2009, and December 31, 2019, were enrolled in this retrospective, real-world study. Survival rates were presented using Kaplan-Meier curves and compared using log-rank tests. Univariable and multivariable Cox proportional hazards regression models were used to identify the predictors of overall survival (OS). Subgroup analyses were conducted for patients with advanced-stage HPSCC (stages III and IV and category T4).
UNASSIGNED: A total of 527 patients with HPSCC were included. Patients receiving SRC (surgery, radiotherapy [RT], and chemotherapy) showed the best OS (p < 0.0001). In comparison with RT alone, both surgery alone (all cases: hazard ratio [HR] = 0.39, p = 0.0018; stage IV cases: HR = 0.38, p = 0.0085) and surgery-based multimodality treatment (SBMT; all cases: HR = 0.27, p < 0.0001; stage IV cases: HR = 0.30, p = 0.00025) showed prognostic benefits, while SBMT also showed survival priority over chemoradiotherapy (CRT; all cases: HR = 0.52, p < 0.0001; stage IV cases: HR = 0.59, p = 0.0033). Moreover, patients who underwent surgery alone had comparable OS to those who underwent SBMT (all patients: p = 0.13; stage IV cases: p = 0.34), while CRT yielded similar prognostic outcomes as RT alone (all patients: p = 0.054; stage IV cases: p = 0.11).
UNASSIGNED: Surgery alone was comparable to SBMT and superior to RT/CRT in terms of OS in patients with HPSCC. We suggest that surgery should be encouraged for the treatment of HPSCC, even in patients with advanced-stage disease.