Prognostic Factors in Patients With Locally Advanced Hypopharyngeal Squamous Cell Carcinoma After Radical...

To analyze treatment efficacy and prognostic factors in patients with locally advanced hypopharyngeal squamous cell carcinoma (LA-HPSCC) treated with radical radiotherapy (RT)/chemoradiotherapy (CRT).

We retrospectively enrolled LA-HPSCC patients treated with radical RT or CRT during 2015-2021. Clinical and inflammatory factors affecting treatment efficacy were analyzed using SPSS (v27).

In all, 193 patients (179 male and 14 female patients) were enrolled. The 1-year, 3-year, and median overall survival (OS) were 78.2%, 41.1%, and 28.9 months, respectively. The 1-year, 3-year, and median progression-free survival (PFS) were 69.9%, 34.7%, and 21.8 months, respectively. Univariate analysis showed that second primary cancer, albumin-fibrinogen ratio (AFR), platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), clinical T (cT) stage, TNM stage, treatment modality, and short-term treatment response were associated with OS (p < 0.05), while AFR, PLR, cT stage, treatment modality, and short-term response were associated with PFS (p < 0.05). Multivariate analysis revealed AFR and short-term response as independent risk factors for OS and PFS, and cT and second primary cancer as independent risk factors for OS. Compared with those not receiving concurrent chemoradiotherapy (CCRT), those treated with CCRT had improved OS and PFS if they were aged ≥ 70 years, or had N2/N3 or stage III/IVA disease (p < 0.05).

OS and PFS were higher in patients with early cTNM, high AFR, low PLR, CCRT, and good short-term response. Patients with low NLR had higher OS and a higher incidence of second primary cancers (commonly esophageal and lung cancers).