The impact of surgical margin status on the outcomes of locally advanced hypopharyngeal squamous cell carcinoma treated by primary surgery

Abstract

Background: The extent of surgical safety margin remained unclear in hypopharyngeal carcinoma surgery.

Aim: The purpose of this study was to evaluate the influence of surgical margin status on the outcomes of patients with advanced hypopharyngeal carcinoma.

Material and methods: A retrospective analysis of clinical data was performed in 205 patients with stage III/IV hypopharyngeal carcinoma treated by primary surgery between January 2005 and December 2014. There were 129 patients with clear surgical margins (≥5 mm) and 76 with close surgical margins (<5 mm). The clinical characteristics and treatment outcomes were compared between the two groups.

Results: Close surgical margin (cSM) was found to be a significant risk factor for local recurrence, overall survival (OS) and disease-specific survival (DSS). Analysis by stratification according to pT classification showed that the OS and DSS rates of T1/T2 tumors with clear surgical margins (nSM) were significantly higher than those with cSM (p < .05), while there was no significant difference in the OS and DSS rates between T3/T4 tumors with cSM and nSM (p > .05).

Conclusions and significance: The tailored extent of surgical resection margin was recommended for locally advanced hypopharyngeal carcinomas according to primary tumor stage.

Chinese abstract

背景：下咽癌手术中的手术安全边缘带的范围尚不清楚。

目的：探讨手术边缘状态对晚期下咽癌患者预后的影响。

材料与方法：回顾性分析2005年1月至2014年12月初次手术治疗的205例III/IV期下咽癌患者的临床资料。手术边缘清晰（5 mm）的患者129例, 手术边缘闭合（<5 mm）的患者76例。比较两组的临床特点和治疗结果。

结果：闭合性手术边缘（cSM）是局部复发、总生存率（OS）和疾病特异性生存率（DSS）的重要危险因素。根据pT分类进行了分层分析, 显示T1/T2肿瘤手术边缘清晰（nSM）的OS和DSS率明显高于cSM（P<.05）, 而cSM和nSM的T3/T4肿瘤的OS率和DSS率无显著差异（P>.05）。

结论与意义：根据原发肿瘤的发展期, 对于局部晚期下咽癌患者治疗, 建议手术切除边缘的范围。

Keywords:

• Advanced hypopharyngeal cancer
• surgical margins
• local recurrence
• prognosis

Disclosure statement

No potential conflict of interest was reported by the authors.