本研究的目的是利用全国数据库阐明全咽喉切除术 (TPL) 或放化疗 (CRT) 是否能为 T4aM0 下咽癌 (HPSCC) 患者提供更好的预后结果。所有数据均来自美国头颈癌登记处日本，提取了 2011 年至 2015 年间新诊断为 T4aM0 HPSCC 患者的信息。主要终点是疾病特异性生存（DSS），次要终点是总生存（OS）。治疗权重逆概率 (IPTW) 调整用于生存分析。我们的队列包括 1143 名患者。 TPL 组和 CRT 组分别包括 724 名患者和 419 名患者。 IPTW 调整后，TPL 组的 OS 和 DSS 均显着长于 CRT 组（分别为 P = .02 和 P = .002）。与 TPL 治疗组相比，T4aM0 HPSCC 患者的生存优势得到证实。接受 CRT 治疗的患者。© 2024。外科肿瘤学会。

The purpose of this study is to elucidate whether total pharyngolaryngectomy (TPL) or chemoradiotherapy (CRT) provides a better prognostic outcome in patients with T4aM0 hypopharyngeal carcinoma (HPSCC) using a nationwide database.All data were obtained from the Head and Neck Cancer Registry of Japan, and information from patients who were newly diagnosed with T4aM0 HPSCC between 2011 and 2015 was extracted. The primary endpoint was disease-specific survival (DSS), and the secondary endpoint was overall survival (OS). The inverse probability of treatment weighting (IPTW) adjustments was used for survival analyses.Our cohort included 1143 patients. The TPL and CRT groups included 724 and 419 patients, respectively. Following IPTW adjustments, both the OS and DSS of the TPL group were significantly longer than those of the CRT group (P = .02 and P = .002, respectively).Survival superiority was demonstrated for patients with T4aM0 HPSCC treated with TPL compared with those treated with CRT.© 2024. Society of Surgical Oncology.