Primary Surgery Beneficial in Advanced Throat Cancers

Patients with cancer of the mid- and lower throat may have higher survival rates if their initial treatment includes surgery, according to a new study.

Researchers at Koo Foundation Sun Yat-Sen Cancer Center (KFSYSCC; Taipei City, Taiwan) conducted an observational study, identifying all newly-diagnosed oropharyngeal (OP) and hypopharyngeal (HP) cancer patients in Taiwan, based on national health insurance claims and the Taiwan cancer registry database. In all, 2,387 OP and 2,315 HP cancer patients diagnosed between 2004 and 2009 were identified, who were then followed until 2012. Radical surgery was performed on slightly more than one-third of OP cancer patients, while approximately half of HP cancer patients had surgery.

The researchers compared outcomes in those who had surgery and those who did not, regardless of whether they received concurrent chemoradiotherapy (CCRT). The results showed that for stage IVa OP cancer, overall survival at five years was 51% for those who had surgery versus 40% without. Similarly, in stage IVa HP cancer, 39% of those who had surgery were alive at five years, compared to 26%, of those who did not. The study was presented at the European Cancer Congress, held during September 2015 in Vienna (Austria).

“The emphasis on organ preservation has led to declining use of surgery. CCRT has become the standard approach for head and neck cancers which cannot be operated on, and it is being used alone even where surgery is possible,” said lead author and study presenter Chih-Tao Cheng, MD. “With the improvement of surgical techniques, including minimally invasive procedures, there's a need to revisit the various treatment options and look at the overall survival of different treatment groups.”

“Surgical treatment of advanced head and neck is a well-recognized weapon that is very often followed by radiotherapy with or without chemotherapy, followed by the assessment of risk from pathology samples,” commented Lisa Licitra, MD, of Istituto Nazionale Tumori (Milan, Italy), and spokesperson of the European Society for Medical Oncology (ESMO). “These data further underline the need to perform prospective research to elucidate the role of surgery and radiotherapy within the curative treatment approaches.”

The oropharynx connects the rear of the mouth to the top of the throat, and includes the posterior portion of the tongue and tonsils. The hypopharynx is the lower throat, which connects the oropharynx to the origin of the trachea and esophagus.

Related Links:
Koo Foundation Sun Yat-Sen Cancer Center
Istituto Nazionale Tumori