Prognostic significance of human papillomavirus status and treatment modality in hypopharyngeal cancer.
BACKGROUND
Management of hypopharynx cancer is often extrapolated from larynx cancer. This report analyses treatment patterns and survival limited to hypopharynx cancer using the National Cancer Database (NCDB).


METHODS
There are 9314 patients diagnosed with hypopharynx cancer between 2004 and 2016. The association between treatment modality and survival was analyzed using Kaplan-Meier survival curves and multivariable Cox regression.


RESULTS
Five-year overall survival ranged from 45% for stage I to 21% for stage IVB. Treatment modality did not influence survival in stage I/II. For stage III/IV, chemoradiation and surgery + adjuvant therapy were equivalent. Surgery yielded improved survival for T4 disease. Human papillomavirus (HPV)-positive tumors were present in 21% and were associated with improved hazard ratio of death (0.60, p = <0.0001).


CONCLUSIONS
Survival is superior for T4 hypopharynx cancer managed with surgery, while treatment modality does not impact outcomes for other T-stages. HPV-positive tumors are associated with improved survival regardless of treatment.
['Burbure|Nina|N|0000-0002-9460-0730', 'Handorf|Elizabeth|E|', 'Ridge|John A|JA|', 'Bauman|Jessica|J|0000-0001-8691-0387', 'Liu|Jeffrey C|JC|0000-0001-8377-0905', 'Giri|Anshu|A|', 'Galloway|Thomas J|TJ|0000-0002-5730-2099']
D052685:Alphapapillomavirus D002294:Carcinoma, Squamous Cell D006258:Head and Neck Neoplasms D006801:Humans D007012:Hypopharyngeal Neoplasms D009367:Neoplasm Staging D027383:Papillomaviridae D011379:Prognosis D012189:Retrospective Studies
hypopharyngeal hypopharynx chemoradiation surgery pyriform sinus