Comparison of functional and oncological results of primary surgery and salvage surgery and primary chemoradiotherapy in hypopharynx cancer

The aim of this study is to compare the oncological and functional results of patients who underwent primary chemoradiotherapy (CRT) and primary surgery and salvage surgery in hypopharyngeal cancer. Retrospectively examined total of 69 patients were included in the study. Of these patients, 38 were assigned to the primary CRT group, 19 to the primary surgery group and 12 to the salvage surgery group. 38 patients in the primary CRT group and all of 19 patients in the primary surgery group were compared to eachother. It was determined that 13 patients in the primary surgery group had undergone flap reconstruction. These 13 patients in the primary surgery group who underwent reconstruction and 12 patients in the salvage surgery group that reconstructed with flap were compared to eachother. There was no statistically significant difference in disease-free survival (p=0.293) and overall survival (p=0.323) between primary CRT (38 patients) and primary surgery groups (19 patients). Lymph node metastasis was found to be an important prognostic factor for disease-free survival (p=0.025). There was no statistically significant difference in complication rates between the flap-reconstructed salvage surgery group (12 patients) and the flap-reconstructed primary surgery group (13 patients), (p=0.202). There was no statistically significant difference between the groups in terms of overall survival (p=0.060). In terms of disease-free survival; it was found to be statistically significantly lower in the salvage surgery group (p=0.036). There was no significant difference in survival between CRT and surgery as primary curative treatment. There was no significant difference in complication rates between primary surgery and salvage surgery groups. It was determined that the contribution of salvage surgery to survival was quite low.