Hypopharyngeal Squamous Cell Carcinoma: Treatment Results in 138 Consecutively Admitted Patients

Johansen, Lars Vendelbo; Grau, Cai; Overgaard, Jens

doi:10.1080/028418600750013465

Cited by 66 publications

(12 citation statements)

References 42 publications

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“…In the retrospective analysis of Elias et al [32] on treatment results of carcinoma of the pyriform sinus, 32.0% of patient population developed distant metastases. The frequency of DM of 46.7% as first site of failure in our study was ten fold higher compared to the results reported by Johansen et al [2]. Although it is generally considered that locoregional control of head and neck cancer represents an important factor for development of distant metastases, we did not observe any distant metastases development preceded by occurrence of locoregional recurrence.…”

Section: Discussioncontrasting

confidence: 76%

“…In the study of Yoon et al [30], the 3-year locoregional control for the group treated with CRCT was 52.0%. Johansen et al [2] in their study of treatment results in 138 patients with hypopharyngeal carcinoma reported low rates of locoregional control at 5 years (25.0%). The 2-year DMFS rate in our study was 64.7%.…”

Section: Discussionmentioning

confidence: 99%

“…This radical approach of treatment, lead to the loss of natural speech function and impairment of swallowing ability with a consequent negative impact on the quality of life, and low cure rates, reported 5-year survival between 20.0% and 50.0% [1,2,7,11,12]. …”

Section: Introductionmentioning

confidence: 99%

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Concurrent radiochemotherapy in advanced hypopharyngeal cancer

2010

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BackgroundConcurrent platinum-based radiochemotherapy has been recommended as a standard of care in patients with locally advanced squamous cell head and neck carcinomas. Unfortunately, there is a lack of level one evidence on best treatment approach for advanced hypopharyngeal cancer. This report aims to summarize the results of our study on concurrent radiochemotherapy in patients with advanced hypopharyngeal cancer.MethodsA retrospective analysis of 41 patients with stage III-IV hypopharyngeal cancer was performed. All patients were treated with three dimensional conformal radiotherapy and received 70 Gy in 35 fractions (2 Gy per fraction, 5 fractions per week). In dependence of the period when radiotherapy was realized, two different treatment techniques were used. Concurrent chemotherapy consisted of cisplatin 30 mg/m2 given on a weekly basis.ResultsThe median age was 52 years (range 29-70). Stage IV disease was recognized in 73.2% of the patients. Complete response rates at the primary site and at the metastatic neck lymph nodes were 68.3% and 36.6%, respectively. A complete composite response was present in 27 patients (65.9%). Median follow-up was 13 months (range 7-36). Distant metastases as initial failure occurred in 7 patients (46.7%). The 2-year local relapse-free survival and regional relapse-free survival rates were 55.2% and 75.8%, respectively. The 2-year locoregional relapse-free survival rate was 51.3%. The 2-year disease-free survival and overall survival rates were 29.3% and 32.8%, respectively. Confluent mucositis was developed in 46.3% of patients. Leucopenia grade 1 was the most frequent hematological toxicity. The median weight loss at the end of treatment was 12% (range 5-21). The worst grade of late toxicity was most commonly pronounced in the skin and in the subcutaneous tissue.ConclusionsBased on unsatisfactory results in our study we suggest that the use of sequential radiochemotherapy or chemotherapy given concomitantly with altered fractionation radiotherapy with the implementation of intensity-modulated radiotherapy as radiotherapy technique could represent treatment approaches able to improve outcome in patients with advanced hypopharyngeal cancer.

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Section: Discussioncontrasting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

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Concurrent radiochemotherapy in advanced hypopharyngeal cancer

2010

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“…Previously, pharyngeal cancer was usually detected at advanced stages, and its prognosis has been poor [ 8 ]. Surgical resection for advanced pharyngeal cancer is necessary, which could cause swallowing disorders, dysgeusia defect, speech problem, and serious cosmetic deformities of the neck [ 8 , 9 ]. ESD was first developed in the gastrointestinal tract and has been widely used because of its less invasion and good clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

A modified endoscopic submucosal dissection for a superficial hypopharyngeal cancer: a case report and technical discussion

Xie

et al. 2017

BMC Cancer

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BackgroundAdequate working space and a clear view for the dissected lesion are crucial for endoscopic submucosal dissection (ESD). Pharyngeal ESD requires that an otorhinolaryngologist creates working space by lifting the larynx with a curved laryngoscope. However, many countries do not have this kind of curved laryngoscope, and the devices could interfere with endoscope because of the narrow space of the pharynx. To overcome these issues, we used a transparent hood (Elastic Touch, slit and hole type, M (long), Top company, Tokyo Japan) instead of the curved laryngoscope to create adequate working space by pushing the larynx, and pharyngeal ESD could be done by gastroenterologists.Case presentationA 64-year-old male patient was admitted to our hospital because of chronic persistent swallowing dysfunction for 2 years. Oesophagogastroduodenoscopy showed a superficial hypopharyngeal cancer in the right pyriform sinus. We used a transparent hood (Elastic Touch, slit and hole type, M (long), Top company, Tokyo Japan) instead of the curved laryngoscope to create adequate working space by pushing the larynx, and dental floss tied to a haemoclip was applied to create counter traction during ESD. The lesion was pathologically confirmed as superficial squamous cell carcinoma and resected completely.ConclusionsThis is the first report of modified ESD for a superficial hypopharyngeal cancer. The modified ESD enables early pharyngeal superficial cancer to be removed completely under endoscope by gastroenterologist.Electronic supplementary materialThe online version of this article (10.1186/s12885-017-3685-7) contains supplementary material, which is available to authorized users.

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“…Regarding different therapy concepts for stage I and II hypopharyngeal carcinomas, the 5-year survival rate averages between 52% and 77% for radiotherapy (with or without concomitant chemotherapy) [201], [202], [203], [204], between 56% and 77% for supraglottic or supracricoid hemilaryngopharyngectomy (with or without induction chemotherapy, neck dissection or postoperative radiotherapy) [205], [206], [207], [208], and between 70% and 73% for transoral laser microsurgery (with or without neck dissection or postoperative radiotherapy) [209], [210], [211]. The 5-year survival rates for stage III and IV hypopharyngeal carcinomas are 19%–37% for radiotherapy (with or without concomitant chemotherapy) [212], [213], [214], [215], and 47%–59% for transoral laser microsurgery (with or without neck dissection or postoperative radiotherapy) [209], [210]. Induction chemotherapy followed by radiotherapy achieved a 5-year survival rate of 38% in stage III and IV hypopharyngeal carcinomas [216].…”

Section: Carcinomas Of the Hypopharynxmentioning

confidence: 99%