The Natural History of Patients With Squamous Cell Carcinoma of the Hypopharynx

OBJECTIVES/HYPOTHESIS: To provide the baseline information on the natural history of patients with squamous cell carcinoma of the hypopharynx to help clinicians, researchers, and patients assess the relative effectiveness of treatment options when the best treatment is not known and newer treatments are being proposed. STUDY DESIGN: Retrospective population-based design. METHODS: The patient descriptors, treatments, and outcomes for 595 patients across the province of Ontario, Canada from January 1990 to December 31, 1999 based on electronic data and chart review. RESULTS: The typical patient is 65 years old, male, unemployed, and poor. They are heavy drinkers with significant comorbidity compromising functional status. The tumors are advanced (over 50% stage 4). After curative treatment 20% had residual disease, recurrences tended to appear in the first year and 50% of first recurrences included metastases. Overall, 47% of patients were disease free at 3 years but eventually 64% of patients died of their cancer. CONCLUSIONS: This information can be used by clinicians and researchers to understand the natural history of the patient group to critically assess both the selection bias and effectiveness of treatments.