RELATIVE PROGNOSTIC IMPORTANCE OF HISTOLOGIC INVASION OF THE LARYNGEAL FRAMEWORK BY HYPOPHARYNGEAL CANCER

This study assessed the relative prognostic importance of histologic i nvasion of the laryngeal framework by hypopharyngeal cancer. The laryn geal specimens and medical records of 55 patients found to have primar y hypopharyngeal cancer between 1962 and 1988 were reviewed. Full 3-ye ar follow-up information was obtained for 51 patients. The overall 3-y ear survival rate was 43% (22/51). The 3-year survival rate was 55% (1 7/31) without histologic invasion versus 25% (5/20) with invasion (p < .05). To assess how invasion affected survival rates in conjunction w ith clinical predictors, we divided the cohort into two groups (mild v ersus severe illness) based on the presence or absence of anemia and c omorbidity. Only in the group with mild illness did histologic invasio n 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 lary ngeal framework.