Abstract
We have been treating patients with hypopharyngeal squamous cell carcinoma at our department for several years. There have been two major treatment transitions in the last few decades: introduction of reconstruction using free jejunal flaps after total pharyngo-laryngectomy in 1989, and introduction of neoadjuvant chemotherapy or chemoradiation therapy for larynx preservation in 2000. We investigated the treatment outcomes by classifying the treatment period into three terms: 1971–1988 (Period A); 1989–1999 (Period B); and 2000–2018 (Period C). The 5-year overall survival (OS) and disease-specific survival (DSS) rates in Period A, Period B, and Period C were 27.1%, 33.8%, and 58.6% (P < 0.001) and 38.5%, 57.7%, and 69.8% (P < 0.001), respectively. In addition, the 5-year laryngectomy-free survival (LFS) rates in Period A, Period B, and Period C were 5.8%, 8.9%, and 36.7% (P < 0.001), respectively. Among the patients treated during the three periods, patients treated in Period C showed significantly improved and more favorable OS, DSS, and LFS rates. It is considered that the increase in the adoption rate of transoral surgery for early-stage cancer because of advancements in endoscopic techniques and introduction of induction chemotherapy and definitive chemoradiation therapy for advanced cancer contributed greatly to improvement of the survival and laryngeal preservation rates in the patients treated in Period C.
