TABLE I.
Characteristics of Selected Cohort of Patients With Stage III or IV (M0) Hypopharyngeal Squamous Cell Carcinoma Diagnosed Between 2004 and 2015 in the Surveillance, Epidemiology, and End Results Database.*
| Characteristics† | CRT, n = 1,892 | Surgery + RT, n = 133 | Surgery + CRT, n = 303 | Total, n = 2,328 | P Value‡ |
|---|---|---|---|---|---|
| Age | 61.95 ± 9.96 | 64.30 ± 10.16 | 60.89 ± 9.02 | 61.95 ± 9.88 | .004§ |
| Sex | .54 | ||||
| Female | 316(16.7%) | 18 (13.5%) | 54 (17.8%) | 388 (16.7%) | |
| Male | 1,576 (83.3%) | 115 (86.5%) | 249 (82.2%) | 1,940 (83.3%) | |
| Race and ethnicity | .089 | ||||
| NHW | 1,297 (68.6%) | 96 (72.2%) | 209 (69.0%) | 1,602 (68.8%) | |
| NHB | 326 (17.2%) | 21 (15.8%) | 37 (12.2%) | 384 (16.5%) | |
| NHO | 125 (6.6%) | 5 (3.8%) | 30 (9.9%) | 160(6.9%) | |
| Hispanic | 144 (7.6%) | 11 (8.3%) | 27 (8.9%) | 182 (7.8%) | |
| Marital status | .49 | ||||
| Single | 445 (25.0%) | 32 (25.2%) | 63 (22.1%) | 540 (24.7%) | |
| Married | 911 (51.2%) | 72 (56.7%) | 152 (53.3%) | 1,135(51.8%) | |
| Divorced/widowed | 422 (23.7%) | 23 (18.1%) | 70 (24.6%) | 515(23.5%) | |
| Insurance‖ | .26 | ||||
| Uninsured | 78 (5.4%) | 1 (1.3%) | 11 (4.7%) | 90(5.1%) | |
| Insured | 1,345 (93.5%) | 73 (97.3%) | 223 (95.3%) | 1,641 (93.9%) | |
| Medicare eligible | 16(1.1%) | 1 (1.3%) | 0 (0.0%) | 17(1.0%) | |
| Primary site | .22 | ||||
| Pyriform sinus | 1,022 (54.0%) | 84 (63.2%) | 174(57.4%) | 1,280 (55.0%) | |
| Postcricoid region | 45 (2.4%) | 2 (1.5%) | 4 (1.3%) | 51 (2.2%) | |
| Aryepiglottic fold | 105 (5.5%) | 4 (3.0%) | 20 (6.6%) | 129(5.5%) | |
| Posterior wall | 124 (6.6%) | 5 (3.8%) | 17 (5.6%) | 146(6.3%) | |
| Overlapping lesion | 65 (3.4%) | 1 (0.8%) | 14 (4.6%) | 80 (3.4%) | |
| Hypopharynx, NOS | 531 (28.1%) | 37 (27.8%) | 74 (24.4%) | 642 (27.6%) | |
| Grade | <.001§ | ||||
| Grade I | 64 (3.4%) | 1 (0.8%) | 10 (3.3%) | 75 (3.2%) | |
| Grade II | 752 (39.7%) | 67 (50.4%) | 124(40.9%) | 943 (40.5%) | |
| Grade III | 593 (31.3%) | 54 (40.6%) | 139(45.9%) | 786 (33.8%) | |
| Grade IV | 19(1.0%) | 3 (2.3%) | 4 (1.3%) | 26 (1.1%) | |
| Unknown | 464 (24.5%) | 8 (6.0%) | 26 (8.6%) | 498 (21.4%) | |
| T stage | <.001§ | ||||
| T1/T2 | 763 (40.3%) | 47 (35.3%) | 97 (32.0%) | 907 (39.0%) | |
| T3 | 496 (26.2%) | 28 (21.1%) | 62 (20.5%) | 586 (25.2%) | |
| T4 | 633 (33.5%) | 58 (43.6%) | 144(47.5%) | 835 (35.9%) | |
| N stage | .060 | ||||
| N0 | 251 (13.3%) | 25 (18.8%) | 34 (11.2%) | 310(13.3%) | |
| N1 | 465 (24.6%) | 31 (23.3%) | 70 (23.1%) | 566 (24.3%) | |
| N2a | 59 (3.1%) | 2 (1.5%) | 4 (1.3%) | 65 (2.8%) | |
| N2b | 128 (6.8%) | 10(7.5%) | 19 (6.3%) | 157(6.7%) | |
| N2c | 538 (28.4%) | 45 (33.8%) | 109(36.0%) | 692 (29.7%) | |
| N2, NOS | 329 (17.4%) | 18 (13.5%) | 49 (16.2%) | 396 (17.0%) | |
| N3 | 122 (6.4%) | 2 (1.5%) | 18 (5.9%) | 142 (6.1%) | |
| Overall stage | .003§ | ||||
| III | 455 (24.0%) | 27 (20.3%) | 52 (17.2%) | 534 (22.9%) | |
| IVA | 1,148 (60.7%) | 97 (72.9%) | 207 (68.3%) | 1,452 (62.4%) | |
| IVB | 275 (14.5%) | 8 (6.0%) | 44 (14.5%) | 327 (14.0%) | |
| IVNOS | 14 (0.7%) | 1 (0.8%) | 0 (0.0%) | 15 (0.6%) | |
| Survival, mo | 20 (10–45) | 25 (10–51) | 25 (12–59) | 21 (10–47) | .002§ |
Subjects were included in the chemoradiation group if they had radiation prior to any surgery plus chemotherapy. Subjects were included in the surgery with the adjuvant therapy group if they received primary surgery with either adjuvant radiation or adjuvant radiation and chemotherapy.
Plus–minus values are mean ± standard deviation for normally distributed continuous variables. Values for nonnormal continuous variables are reported as median (interquartile range). Frequencies are reported as number (proportion of overall group within column).
Normally distributed continuous variables were assessed using an analysis of variance. Continuous variables with nonnormal distribution were assessed with the Kruskall-Wallis test. χ2 tests were used to assess categorical variables.
Statistically significant.
Insurance status was stratified by age of 65 years due to known concerns about accuracy of insurance data. Subjects were classified as Medicare eligible if filed as uninsured but over the age of 65 years at the time of diagnosis. Insurance status was only available for the years 2007 to 2015 within the Surveillance, Epidemiology, and End Results database and was missing for 453 subjects in the CRT group, 59 in the S + RT group, and 69 in the S + CRT group.
CRT = chemoradiation; NHB = non-Hispanic black; NHO = non-Hispanic other; NHW = non-Hispanic white; NOS = not otherwise specified; S + CRT = surgery with adjuvant CRT; S + RT = surgery with adjuvant radiation therapy.