Relative Prognostic Importance of Histologic Invasion of the Laryngeal Framework by Hypopharyngeal Cancer

This study assessed the relative prognostic importance of histologic invasion of the laryngeal framework by hypopharyngeal cancer. The laryngeal specimens and medical records of 55 patients found to have primary hypopharyngeal cancer between 1962 and 1988 were reviewed. Full 3-year follow-up information was obtained for 51 patients. The overall 3-year survival rate was 43% (22/51). The 3-year survival rate was 55% (17/31) without histologic invasion versus 25% (5/20) with invasion (p <.05). To assess how invasion affected survival rates in conjunction with clinical predictors, we divided the cohort into two groups (mild versus severe illness) based on the presence or absence of anemia and comorbidity. Only in the group with mild illness did histologic invasion provide additional prognostic information. These results demonstrate that the inclusion of clinical variables in predictions of prognosis can strikingly alter the prognostic importance of invasion of the laryngeal framework.