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Glasgow prognostic score and neutrophil-lymphocyte ratio are good prognostic indicators after radical neck dissection for advanced squamous cell carcinoma in the hypopharynx

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Abstract

Purpose

Locally advanced carcinomas arising in the hypopharynx have been traditionally treated by resection of the hypopharynx, larynx, and cervical esophagus. However, the prognosis of these patients is still low. In the present study, we retrospectively analyzed the long-term survival of patients with locally advanced hypopharyngeal squamous cell carcinoma (HSCC) reconstructed by jejunal graft.

Methods

Between 2004 and 2014, 68 patients with HSCC were treated at Tottori University Hospital. Nine patients with synchronous esophageal cancer were excluded. We analyzed the overall survival of 59 patients with clinical stage III and IV HSCC who underwent pharyngo-laryngo-cervical esophagectomy with definitive tracheostomy followed by free jejunal graft reconstruction. Additionally, prognostic significances of preoperative patients’ Glasgow prognostic score (GPS), neutrophil-lymphocyte ratio (NLR), and prognostic nutritional index were analyzed.

Results

Postoperative complications occurred in 18.6 % of 59 patients. There were no cases of graft loss, and no patient died from complications. Preoperative poor performance status of patients was a risk factor for postoperative complications. The 5-year overall survival rate of the 59 patients was 46.1 %, and the median survival time was 28 months. In univariate and multivariate survival analyses, high GPS (1 or 2), and high NLR (≥5) were recognized as independent poor prognostic markers for patients with HSCCs.

Conclusions

Pharyngo-laryngo-cervical esophagectomy followed by free jejunal reconstruction was performed safely. Additional treatment, such as chemoradiotherapy, should be introduced for patients with high preoperative GPS or NLR after curative operation.

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Acknowledgments

We thank Dr. Bin Nakayama for performing the microvascular anastomoses.

This study was not funded.

Authors’ contributions

Study conception and design: Masahide Ikeguchi

Acquisition of data: Masahide Ikeguchi

Analysis and interpretation of data: Masahide Ikeguchi

Drafting of manuscript: Masahide Ikeguchi

Critical revision of manuscript: edanzediting.co.jp

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Authors and Affiliations

  1. Tottori Prefectural Central Hospital, 730 Ezu, Tottori, 680-0901, Japan

    Masahide Ikeguchi

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  1. Masahide Ikeguchi
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Correspondence to Masahide Ikeguchi.

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The author declares that he has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Ikeguchi, M. Glasgow prognostic score and neutrophil-lymphocyte ratio are good prognostic indicators after radical neck dissection for advanced squamous cell carcinoma in the hypopharynx. Langenbecks Arch Surg 401, 861–866 (2016). https://doi.org/10.1007/s00423-016-1453-9

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  • DOI: https://doi.org/10.1007/s00423-016-1453-9

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