Management of advanced hypopharyngeal carcinoma: systematic review of survival following surgical and non-surgical treatments

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<jats:title>Abstract</jats:title><jats:sec id="S0022215118000555_sec_a1"><jats:title>Background:</jats:title><jats:p>Advanced hypopharyngeal carcinoma has a dismal prognosis. The optimal treatment for these patients remains under debate. This systematic review aimed to compare survival following surgical and non-surgical treatments.</jats:p></jats:sec><jats:sec id="S0022215118000555_sec_a2"><jats:title>Methods:</jats:title><jats:p>A systematic review was conducted of randomised studies, with a descriptive analysis of retrospective observational studies.</jats:p></jats:sec><jats:sec id="S0022215118000555_sec_a3"><jats:title>Results:</jats:title><jats:p>Two randomised trials and 11 observational studies were included in the review. A meta-analysis of randomised trials reported a hazard ratio of 0.89 for overall survival in favour of surgical treatment (<jats:italic>p</jats:italic> = 0.44). Neither treatment was favoured in terms of overall survival. Observational studies did not report a survival advantage with either treatment. The five-year larynx preservation rates for non-surgically treated patients were between 38 and 58 percent.</jats:p></jats:sec><jats:sec id="S0022215118000555_sec_a4"><jats:title>Conclusion:</jats:title><jats:p>Chemoradiotherapy offers similar survivorship compared to surgery in advanced disease, while also making larynx preservation feasible. It can be used as a treatment in all patients as an alternative to surgery.</jats:p></jats:sec>

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