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Войти в исследования Cancer medicine · 2026
Survival Outcomes of Post-Induction Treatment Strategies in Patients With Partial Response Hypopharyngeal Squamous Cell Carcinoma: A Propensity Score-Weighted Analysis.
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Lau Hui-Ching, Huang Huiying, Li Ji, Wang Tian, Mao Xinhui, Wang Zhenwei, Hsueh Chi-Yao, Zhang Ming, Xu Chengzhi
Аннотация
BACKGROUND: Most patients with hypopharyngeal squamous cell carcinoma (HPSCC) achieve partial response (PR) after induction chemotherapy. However, optimal post-induction management remains controversial. We compared survival outcomes of post-induction strategies for PR-HPSCC, with emphasis on advanced post-induction tumor stage (ycT) using inverse probability of treatment weighting (IPTW-ATO) to mitigate confounding by indication.
METHODS: This retrospective study included 149 patients with PR-HPSCC after induction chemotherapy who subsequently received surgery-based therapy (SBT; n = 71) or definitive chemoradiotherapy (CRT; n = 78). IPTW-ATO was used to address covariate imbalances between groups. Overall survival (OS) and progression-free survival (PFS) were evaluated using weighted Kaplan-Meier analyses and IPTW-ATO-adjusted Cox proportional hazards models. Sensitivity analyses compared findings across unadjusted, multivariable, and propensity score-weighted models.
RESULTS: In unadjusted analyses, OS and PFS did not differ significantly between groups. After IPTW-ATO adjustment, SBT was associated with improved OS and PFS versus CRT. Exploratory subgroup analyses suggested a potential differential treatment effect across ycT strata; however, interaction tests were not statistically significant, and no significant survival difference was observed in patients with early ycT disease. In multivariable analyses, thyroid invasion was independently associated with worse OS, whereas anti-PD-1 therapy was associated with improved OS.
CONCLUSIONS: Outcomes among patients with PR-HPSCC are heterogeneous. After adjustment for covariate imbalances, SBT was associated with favorable survival. These findings suggest that PR should not be treated as a uniform entity and that post-induction ycT classification may help stratify patients for future prospective evaluation.
METHODS: This retrospective study included 149 patients with PR-HPSCC after induction chemotherapy who subsequently received surgery-based therapy (SBT; n = 71) or definitive chemoradiotherapy (CRT; n = 78). IPTW-ATO was used to address covariate imbalances between groups. Overall survival (OS) and progression-free survival (PFS) were evaluated using weighted Kaplan-Meier analyses and IPTW-ATO-adjusted Cox proportional hazards models. Sensitivity analyses compared findings across unadjusted, multivariable, and propensity score-weighted models.
RESULTS: In unadjusted analyses, OS and PFS did not differ significantly between groups. After IPTW-ATO adjustment, SBT was associated with improved OS and PFS versus CRT. Exploratory subgroup analyses suggested a potential differential treatment effect across ycT strata; however, interaction tests were not statistically significant, and no significant survival difference was observed in patients with early ycT disease. In multivariable analyses, thyroid invasion was independently associated with worse OS, whereas anti-PD-1 therapy was associated with improved OS.
CONCLUSIONS: Outcomes among patients with PR-HPSCC are heterogeneous. After adjustment for covariate imbalances, SBT was associated with favorable survival. These findings suggest that PR should not be treated as a uniform entity and that post-induction ycT classification may help stratify patients for future prospective evaluation.