Oncological Analysis and Surgical Outcomes in Postcricoid Carcinoma: A 14 Years Retrospective Study

Simple Summary High local failure and treatment-related morbidity represent a great challenge for postcricoid carcinoma which appears to be more aggressive and requires more morbid oncologic surgery with reconstruction of the larynx and hypopharynx. This paper presents a retrospective analysis focusing on the evaluation of clinical characteristics, therapeutic approaches, quality of swallowing, voice rehabilitation, and verbal communication after a long-term follow-up. To date, this is the first and largest cohort published to reveal a deep understanding of clinical routines in postcricoid carcinoma. Background: Postcricoid carcinoma is a rare but aggressive type of hypopharyngeal carcinoma with poor prognosis and high mortality; thus, it is indispensable to investigate the surgical efficacy and multimodal strategies. Methods: This retrospective study included postcricoid carcinoma patients undergoing surgical resection from 2008 to 2022. Treatment methods and clinical characteristics were analyzed to evaluate prognostic factors for oncological outcomes. Results: Of 72 patients, 13 cases were in the I-II stage and 59 in the III-IV stage. The overall survival (OS) was 50.0%; the laryngeal function preservation rate was 69.4%. Univariate analysis found that high mortality was associated with low tumor differentiation, lymph node metastasis, neck recurrence, and smoke history via log-rank test (p < 0.05); postoperative radiotherapy (RT) remained positive in OS (p = 0.04). The multivariable model further revealed that lymph node metastasis was a dominant determinant after accounting for covariates (HR 1.75; 95% CI 0.85-3.59). The data also indicated that neoadjuvant chemotherapy (NAC) and tumor diameter <= 2 cm were causing lower rates of pharyngeal fistula and locoregional relapse. Conclusions: Surgeons should emphasize high-risk features and optimize individualized surgical procedures for postcricoid carcinoma patients. Combined with multimodal treatments, it is feasible to reconstruct laryngeal function and lessen postoperative morbidities in advanced patients.

Automated summary

Postcricoid carcinoma is a rare and aggressive type of hypopharyngeal cancer with poor prognosis, requiring investigation of surgical efficacy and multimodal strategies. This study analyzed surgical resection cases from 2008 to 2022, finding associations between prognosis and factors such as tumor differentiation, lymph node metastasis, and treatment methods. Surgeons should focus on high-risk features and individualized surgical procedures to improve outcomes in postcricoid carcinoma patients.