Squamous cell carcinoma of the hypopharynx remains a highly lethal disease. This article documents our experience with 132 patients undergoing surgical management of squamous cell carcinoma of the hypopharynx, of whom 80% received postoperative radiation therapy. Local-regional control was obtained in 61% of the patients. Five-year overall and disease-free survival rates were 30% and 41%, respectively. Prognosis was better in patients with limited disease: local disease permitting larynx-sparing surgery, N0/N1 clinical neck, and stage I/II/III disease. Cancer of the hypopharynx remains an aggressive entity associated with poor prognosis. Novel strategies stressing improved local-regional control with prevention of distant metastasis are warranted.
Get full access to this article
View all access options for this article.
References
1.
BeahrsOHMyersMH, eds. Manual for staging of cancer. Philadelphia: American Joint Committee on Cancer, 1988: 39–47.
2.
FleissJLStatistical methods for rates and proportions. New York: Wiley, 1973: 24.
3.
KaplanEMeierP.Nonparametric estimation for incomplete observation. J Am Stat Assoc1958;53:457–81.
4.
PetoRPikeMCDesign and analysis of randomized clinical trials requiring prolonged observations of each patient. II. Analysis and examples. Lancet1977; 35: 1–39.
5.
PerskyMSDalyJFCombined therapy vs curative radiation in the treatment of pyriform sinus cancer. Otolaryngol Head Neck Surg1981;89:87–91.
6.
DriscollWGNagorskyMJCantrellRWJohnsMECarcinoma of the pyriform sinus: Analysis of 102 cases. Laryngoscope1983;793:556–60.
7.
JohnsonJTBaconGWMyersENWagnerRLMedial vs lateral wall pyriform sinus carcinoma: Implications for management of regional lymphatics. Head Neck1994;16:401–5.
8.
VanderbrouckCEschwegeFDe La RochefordiereA, et al. Squamous cell carcinoma of the pyriform sinus: A retrospective study of 351 cases treated at the Institute Gustav-Roussy. Head Neck1987;10:4–13.
9.
HoCMLamKHWeiWIYuenPWLamLKSquamous cell carcinoma of the hypopharynx—analysis of treatment results. Head Neck.1993; 15: 405–12.
10.
SasakiTMBakerHWYeagerRAMcConnellDBVettoRMAggressive surgical management of pyriform sinus carcinoma. Am J Surg1986;151:590–2.
11.
PingreeTFDavisRKReichmanODerrickL.Treatment of hypopharyngeal carcinoma: A ten-year review of 1362 cases. Laryngoscope1987;97:901–4.
12.
ShahJPShahaARSpiroRHStrongEWCarcinoma of the hypopharynx. Am J Surg1976;132:439–43.
13.
OguraJHMarksJEFreemanRBResults of conservation surgery for cancers of the supraglottis and pyriform sinus. Laryngoscope1980;90:591–600.
14.
LacourreyeHLacauStGuilyJBrasnuDFabreAMenardM.Supracricoid hemilaryngopharyngectomy. Analysis of 240 cases. Ann Otol Rhinol Laryngol1987; 96: 217–21.
15.
MarksJEBreauxSSmithPGThawleySESpectorGGSessionsDGThe need for elective irradiation of occult lymphatic metastases from cancers of the larynx and pyriform sinus. Head Neck1985;8:3–8.
16.
LefebvreJLCastelianBDe La TorreJCDelobelle-DeroideAVankenrmelB.Lymph node invasion in hypopharynx and lateral epilarynx carcinoma: A prognostic factor. Head Neck1987;10:14–8.
17.
LutzCKJohnsonJTMeyersENWagnerRLSupraglottic carcinoma: Patterns of recurrence. Ann Otol Rhinol Laryngol1990;99:12–7.
18.
SpiroRHGalloOShahJPSelective jugular node dissection in patients with squamous carcinoma of the larynx or pharynx. Am J Surg1993;166:339–402.
19.
WeiWILamKHChoiSWongJ.Late problems after pharyn-golaryngoesophagectomy and pharyngogastric anastomosis for cancer of the larynx and hypopharynx. Am J Surg1984;148:509–13.
20.
KrausDHPfisterDGHarrisonLB, et al. Larynx preservation with combined chemotherapy and radiation therapy in advanced hypopharynx cancer. Otolaryngol Head Neck Surg1994;111:31–7.
21.
LefebvreJLSahmoudT.Larynx preservation in hypopharynx squamous cell carcinoma: Preliminary results of a randomized study [Abstract]. Proc Am Soc Clin Oncol1994;283:912.
