Hypopharynx cancer: nomogram stratifies need for adjuvant therapy

  • Heng Y & al.
  • Eur J Surg Oncol
  • 13 Sep 2019

  • curated by Brian Richardson, PhD
  • Univadis Clinical Summaries
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Takeaway

  • A nomogram based on 5 independent factors shows good prognostic value in patients with hypopharyngeal squamous cell carcinoma undergoing pharyngectomy.

Why this matters

  • The tool can help identify patients who will benefit from postoperative adjuvant treatment.

Key results

  • Multivariate factors for poor survival included tumor size (HR, 1.479; P=.001), esophageal invasion (HR, 3.864; P=.000), extracapsular spread/internal jugular vein adhesion (HR, 2.475; P=.001), thyroid gland invasion (HR, 2.420; P=.027), and >3 lymph node metastases (HR, 2.208; P=.002).
  • A nomogram based on these factors had a C-index value of 0.768 (95% CI, 0.719-0.817) in the development cohort and 0.767 (95% CI, 0.753-0.781) after bootstrapping for predicting OS.
  • In stratified analysis based on nomogram score, postoperative adjuvant treatment:
    • was associated with improved OS in high-risk patients (P=.0067),
    • had no significant effect in moderate-risk patients (P=.3708), and
    • reduced OS (P=.0249) in low-risk patients.

Study design

  • 385 patients with primary hypopharyngeal SCC who received pharyngectomy, 187 who received postoperative adjuvant therapy, were included.
  • Funding: Shanghai Shen-kang Hospital; Shanghai Municipality; National Natural Science Foundation of China; Shanghai Science and Technology Development Funds; Shanghai Municipal Health System; Shanghai Municipal Science and Technology Foundation.

Limitations

  • Retrospective study design.