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Management of advanced hypopharyngeal carcinoma: systematic review of survival following surgical and non-surgical treatments

Published online by Cambridge University Press:  12 June 2018

A Habib
A Habib*
Affiliation:
Department of Ear, Nose and Throat, Nottingham University Hospitals NHS Trust, Nottingham City Hospital, UK
*
Address for correspondence: Dr Ayaaz Habib, Department of Ear, Nose and Throat, Nottingham University Hospitals NHS Trust, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK E-mail: ayaaz.habib@nhs.net
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Abstract

Background:

Advanced hypopharyngeal carcinoma has a dismal prognosis. The optimal treatment for these patients remains under debate. This systematic review aimed to compare survival following surgical and non-surgical treatments.

Methods:

A systematic review was conducted of randomised studies, with a descriptive analysis of retrospective observational studies.

Results:

Two randomised trials and 11 observational studies were included in the review. A meta-analysis of randomised trials reported a hazard ratio of 0.89 for overall survival in favour of surgical treatment (p = 0.44). Neither treatment was favoured in terms of overall survival. Observational studies did not report a survival advantage with either treatment. The five-year larynx preservation rates for non-surgically treated patients were between 38 and 58 percent.

Conclusion:

Chemoradiotherapy offers similar survivorship compared to surgery in advanced disease, while also making larynx preservation feasible. It can be used as a treatment in all patients as an alternative to surgery.

Keywords

HypopharynxCarcinomaSurvivalSurgical Procedures, OperativeConcurrent ChemoradiotherapyLarynxOrgan Preservation
Type
Review Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 5 , May 2018 , pp. 385 - 400
Copyright
Copyright © JLO (1984) Limited 2018 

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