Carcinoma Of The Pyriform Sinus A Comparison Of Treatment Modalities

Abstract

One hundred four patients with epidermoid carcinoma of the pyriform fossa were reviewed retrospectively. Survival, local recurrence and metastatic rates were all compiled for the purpose of comparing the efficacy of combined therapy with radiation therapy and surgery alone in treating such lesions. Combined therapy consisted of 4500 rad Cobalt60 therapy at 200 rads per day preoperatively. All lesions were staged according to AJC classification. There was a similar stage distribution of patients in each therapeutic category. Three‐year determinate survival rates were as follows: radiation therapy—10%, surgery—56%, and combined therapy—40%. Evaluation of the local recurrence rate revealed it to be: radiation threapy—19/33 (58%), surgery—1/19 (5%), and combined therapy—9/32 (28%). We interpret this data to suggest that preoperative irradiation impaired the determination of adequate resection margins, despite the use of frozen sections from those margins at the time of surgery. The incidence of late contralateral palpable nodes was greatest in the surgery group—5/19 (26%), compared with radiation therapy—0/33, and combined therapy—1/32 (3%) . This supports other studies which indicate that radiation therapy is very effective in controlling subclinical nodal metastases.

Analysis of Recurrence and Survival after Hypopharyngeal Ablative Surgery with Radial Forearm Free Flap Reconstruction

“…Local recurrence for pyriform sinus cancer has been reported to occur within the first year 79% of the time. 5 The median time to recurrence in this series was 10 months. Kaplan-Meier curves ( Figs.…”

Surgery and Postoperative Radiotherapy and Radiotherapy Alone in T3-T4 Cancers of the Pyriform Sinus: Treatment results and patterns of failure

“…Some investigators have advocated preoperative radiotherapy ( 15,16), whereas others prefer postoperative radiotherapy (9, [17][18][19]. Although preoperative radiotherapy might have the theoretical advantage of a better oxygen supply to the tissues, it also has disadvantages, since it may make complete resection more difficult and may be associated with an increased frequency of complications ( 5 , 19,20).…”

Clinico-Endoscopic and Radiological Assessment in the Pretherapeutic Staging of Laryngeal and Hypopharyngeal Malignancies

“…23 Eisbach KJ et al (1977) reported that in hypo pharyngeal malignancies mean age of presentation was 60 years. 6 Zoller et al (1978) in their study had reported mean age for the head and neck malignancies as 59.5 years. 24 reported the peak incidence of hypopharyngeal carcinoma as 60 years.…”

“…Pyriform fossa and post pharyngeal wall have male predominance of 5-20:1 in North America with 50:1 in France. 5,6,7 Post cricoids lesions have a female predominance 1.5:1. [8][9][10] Clinico-endoscopic Evaluation; Clinico-endoscopic evaluation can be undertaken with Indirect laryngoscopy (I/L), Fibreoptic laryngoscopy (FOL) / Telescopic laryngoscopy (70 0 Hopkins) and Direct laryngoscopy.…”