Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2022, Vol. 36 ›› Issue (4): 49-54.doi: 10.6040/j.issn.1673-3770.0.2021.278

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Prevalence and prognostic nomogram for IVc stage hypopharyngeal carcinoma patients: a SEER population-based analysis

JIANG Chao, ZHOU Xuanchen, HAN Jie, YUE Zhiyong   

  1. Department of Otorhinolaryngology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China
  • Published:2022-07-11

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Abstract: Objective Hypopharyngeal carcinoma patients in IVc stage are always associated with poor prognosis and prognostic factors for these patients are largely unknown. We aimed to characterize the prevalence of metastases, and establish a prognostic nomogram for survival prediction. Methods Hypopharyngeal carcinoma patients with IVc stage were collected from surveillance, epidemiology and End Results(SEER)database. Chi-square test was used to analyze the related risk factors of different sites of metastases. Univariate and multivariate Cox regression analyses were performed to analyze the prognostic factors of cancer-specific survival(CSS)in IVc stage patients. The nomogram based on multivariate Cox analysis was then established and validated. Results A total of 283 IVc stage hypopharyngeal carcinoma patients were included in this study. Majority of patients were diagnosed with single metastasis, and lung(53. 7%)was the most common metastasis site. Patients with tumor in pyriform sinus(P=0.029)and high-grade tumors(P=0.010)were more likely to develop lung metastasis. Multivariate Cox analysis showed that bone metastasis(HR=2.239, P<0.001), liver metastasis (HR=1.880, P=0.003), surgical therapy(HR=0.311, P=0.003)and chemotherapy(HR=0.494, P<0.001)were independent prognostic factors for CSS. Independent prognostic factors were integrated into nomogram for CSS prediction, and the C-index was 0.686(95%CI 0.649-0.723). Conclusion Lung metastasis is the most common in IVc stage hypopharyngeal carcinoma patients. For hypopharyngeal carcinoma patients in IVc stage, surgical therapy, chemotherapy, without bone and liver metastases are associated with superior survival outcome. The proposed nomogram has a good predictive ability and may be practical for clinical decision-making.

Key words: Hypopharyngeal carcinoma, Nomogram, Surveillance, Epidemiology, and End Results, Distant metastases

CLC Number: 

  • R739.6
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