Survival outcome by early chemoradiation therapy salvage or early surgical salvage for the treatment of hypopharyngeal cancer

Objective: To compare survival data between patients who had surgery followed by concomitant chemoradiation therapy (CCRT) versus CCRT followed by early surgical salvage. Study Design: Retrospective study. Methods: We retrospectively analyzed 202 patients with hypopharyngeal carcinoma (HPC) who were treated with different treatment strategy according to the choice of the patients by surgery first or CCRT first. In 72 (35.6%) cases, the primary treatment was surgery. Postoperative radiation therapy was given to 47 patients. Radiation therapy was the primary treatment in 130 (64.4%) patients; among them, 69 (34.2%) patients received salvage surgery within 2 months after CCRT course if there was a residual tumor visible on post-CCRT CT image or clinically residual tumor. Results and Conclusion: The 5-year disease-specific survival rate was 80% for stage I-II, 44.8% for stage III, and 14.3% for stage IV disease. Surgery plus concomitant chemoradiotherapy led to a better survival rate than CCRT plus salvage surgery in patients with stage III-IV HPC.