Prognostic factors impacting survival rates of hypopharyngeal cancer with nomogram prediction: a SEER-based study

Background: We analyzed prognostic factors of hypopharyngeal carcinoma and developed a nomogram to predict survival rates in non-metastatic (M0) patients. Subjects and methods: We included 4068 hypopharyngeal carcinoma patients identified from the Surveillance, Epidemiology, and End Results Program database between 2004 and 2015 in a retrospective cohort study. We analyzed prognostic factors of hypopharyngeal carcinoma using cause-specific and overall survival rates. We developed a nomogram to predict patients’ survival rates by multivariate Cox regression. Results: Five-year survival rates of all stages between 2004 and 2010 were 25–35%. Radiotherapy pre- and post-surgery was the best modality of treatment according to 1-year and 5-year survival rates. The worst survival was in the posterior wall of the hypopharynx significantly (HRs [95% CI], P) (1.238 [1.045–1.466], P = 0.013). The highest survival rate was for the combination of surgery and radiotherapy pre- and post-surgery compared to radiation pre-surgery (0.532 [0.231–1.225], P = 0.138). Our nomogram revealed a better predictive probability over the 6th AJCC-TNM classification for predicting 5-year overall survival. Conclusions: The worst survival was old age hypopharyngeal carcinoma patients, with the primary site in the posterior wall of the hypopharynx. The best survival was linked to receiving radiotherapy pre- and post-surgery. Our nomogram revealed a better predictive probability over TNM classification for predicting 1- and 5-year overall survival, which enables clinicians to make better treatment recommendations.