Hypopharyngeal cancer trends in a high-incidence region: A retrospective tertiary single center study

Table 1 Squamous cell carcinoma of the oral cavity, larynx, oropharynx and hypopharynx, as stated by European Head and Neck Society-European Society for Medical Oncology-European Society of Radiotherapy & Oncology Clinical Practice guidelines for diagnosis, treatment and follow-up-management of hypopharyngeal cancer (Stage I-IV B)

TNM Stage	Standard	Option
cT1-2 cN0 cM0	RT
	Conservation larynx surgery (T and N), followed by RT and CRT if indicated
cT1-2 cN1-3 M0; cT3 cN0-3 M0	Concomitant CRT	Surgery followed by RT or CRT if indicated
	If laryngectomy necessary, concomitant CRT (T and N), or induction ChT followed by RT (T and N) in case of complete or partial response after induction or surgery in case of stable or progressive disease after induction
cT4a cN0-3 cM0	Surgery (T and N), followed by RT or CRT if indicated	CRT
		Induction ChT followed by RT (T and N) in case of complete or partial response after induction or surgery (T and N) in case of stable or progressive disease after induction
cT4b cN0-3 cM0		Induction ChT followed by RT for responders (T and N)
		Concomitant CRT
		Palliative treatment: systemic ChT/ immunotherapy and/or palliative RT and/or BSC

BSC: Best supportive care; ChT: Chemotherapy; CRT: Chemoradiotherapy; M: Metastasis; N: Node; RT: Radiotherapy; T: Tumor; TNM: Tumor, node, metastasis.

Table 2 Location patterns of primary tumor

Hypopharynx	Hypopharynx and larynx	Oro-hypopharynx	PEJ	Hypopharynx + larynx + esophageal inlet
11 cases	33 cases	2 cases	6 cases	1 case
20.75%	62.26%	3.77%	11.32%	1.88%

PEJ: Pharyngoesophageal junction.

Table 3 Histopathological subtypes of tumor

Histopathologic subtype	Case number	Percentage
Keratinized	36	67.9%
Non keratinized	6	11.32%
Spindle cell	4	7.54%
Not specified	7	13.2%

Table 4 Grading aspects of the primary tumor

Tumor grading	Case number	Percentage
Grade 1	0	0%
Grade 2	16	30.1%
Grade 3	12	22.64%
Grade 4	1	1.88%
Unspecified	21	39.62%

Table 5 Histopathological investigation of the study showing squamous cell carcinoma, with various subtypes

			Tracheotomy			Total
			Elective	Without	Emergency
Grading	G1	Frequency			3	3
		Percentage of same grading			100.0%	100.0%
		Percentage of tracheotomies			12.0%	5.7%
	G2	Frequency	4	4	8	16
		Percentage of same grading	25.0%	25.0%	50.0%	100.0%
		Percentage of tracheotomies	36.4%	23.5%	32.0%	30.2%
	G3	Frequency		7	5	12
		Percentage of same grading		58.3%	41.7%	100.0%
		Percentage of tracheotomies		41.2%	20.0%	22.6%
	G4	Frequency			1	1
		Percentage of same grading			100.0%	100.0%
		Percentage of tracheotomies			4.0%	1.9%
	N	Frequency	7	6	8	21
		Percentage of same grading	33.3%	28.6%	38.1%	100.0%
		Percentage of tracheotomies	63.6%	35.3%	32.0%	39.6%
Total		Frequency	11	17	25	53
		Percentage of same grading	20.8%	32.1%	47.2%	100.0%
		Percentage of tracheotomies	100.0%	100.0%	100.0%	100.0%

Table 6 American Joint Committee on Cancer and tumor, node, metastasis staging of the cases

AJCC stage	TNM stage	Cases	Percentage
Stage 0	Tis N0 M0	0	0
Stage I	T1 N0 M0	0	0
Stage II	T2 N0 M0	0	0
Stage III	T3 N3 M0; T1-3 N1 M0	5	9.43%
Stage IV A	T4a N0/1 M0; T1-4a N2 M0	30	56.60%
Stage IV B	T4b any N M0; any T N3 M0	14	26.41%
Stage IV C	Any T any N M1	4	7.54%

AJCC: American Joint Committee on Cancer; TNM: Tumor, node, metastasis.

Table 7 Adult Comorbidity Evaluation-27 comorbidities in hypopharyngeal cancer patients

Comorbidities (system affected)	Patients	Percentage	Total
Cardiovascular	37	69.81%	44 cases (83.01%)
Pulmonary	12	22.64%
Diabetes mellitus	15	28.30%
Malignancy (other than the present illness)	9	16.98%
Alergies	1	1.88%
Other comorbidities (gastrointestinal, substance abuse, renal, etc.)	25	47.16%

Table 8 Karnofski Performance Status Scale definitions rating

KPSs grade	Functional capacity level	Patients	Percentage
100%	Normal, no complaints, no evidence of disease	0	0%
90%	Able to carry on normal activity. minor signs or symptoms of disease	1	1.88%
80%	Normal activity with effort; some signs or symptoms of disease	8	15.09%
70%	Cares for self; unable to carry on normal activity or to do active work	6	11.32%
60%	Requires occasional assistance. but is able to care for most of his personal needs	21	39.62%
50%	Requires considerable assistance and frequent medical care	11	20.75%
40%	Disabled; requires special care and assistance	4	7.54%
30%	Severely disabled; hospital admission is indicated although death is not imminent	2	3.77%
20%	Very sick: Hospital admission necessary; active supportive treatment necessary	0	0%
10%	Moribund; fatal process progressing rapidly	0	0%
0%	Dead	0	0%

KPSs: Karnofsky performance scores.

Table 9 Presenting symptoms

Symptom	Frequency	Number of patients
Dysphagia	92.45%	49
Neck mass	90.56%	48
Hoarseness	75.4%	40
Shortness of breath	67.9%	36
Weight loss	52.83%	28
Otalgia	15.09%	8
Hemoptysis	3.77%	2
Headache	3.77%	2

The columns do not total 100% because patients presented more than one symptom at once.