Management of the Patients with Hypopharyngeal Cancer: Eight-Year Experience of Miyagi Cancer Center in Japan

Abstract

The aim of this study is to evaluate the results of treatment for hypopharyngeal cancer and indicate the future prospect of the treatment. Seventy-four patients with squamous cell carcinoma of the hypopharynx admitted to Miyagi Cancer Center from 1993 through 2000 are reviewed. Sixty-four patients received radical treatment, and 10 patients received palliative treatment or no treatment. The cancer was advanced (stages III and IV) in 82% of all the patients. The overall 5-year survival rate of all the patients was 38%. The overall 5-year survival rate of 64 patients received radical treatment was 43%. The ten patients who received palliative treatment or no treatment died of cancer within 16 months. Fifty-two out of the 74 patients underwent neck dissection for the neck lymph node involvement; forty of the 52 patients underwent ipsilateral neck dissection and 12 underwent bilateral neck dissection. Four out of the 40 patients, who underwent ipsilateral neck dissection alone, developed late contralateral regional recurrence but were successfully treated by contralateral neck dissection at the time of recurrence. Twenty-three out of 74 patients had multiple primary cancers synchronously or metachronously (31%). Cause of the death of six patients out of 74 patients was confirmed to be primary cancers other than hypopharyngeal cancer, as judged by physicians in other department or other hospitals. Most of the patients died due to distant metastasis from hypopharyngeal cancer or other primary cancers. We therefore conclude that contralateral elective neck dissection which is frequently chosen for the treatment of hypopharyngeal cancer surgery is unnecessary. Even if locoregional control is accomplished, distant metastasis or multiple primary cancers emerge and make prognosis poor. To improve the prognosis, we should develop some strategy against hypopharyngeal cancer for each patient. New strategies including chemoprevention and surgery against distant metasistasis are necessary.hypopharyngeal cancer; distant metastasis; multiple primary cancers; elective neck dissection

Study of the physicochemical properties of drugs suitable for administration using a lymphatic drug delivery system

“…Lymph node (LN) metastasis is an extremely important factor that determines the prognosis of many types of cancer. It has been estimated that LN metastasis accounts for 20‐30% of all deaths in patients with malignant tumors of the head and neck region 1,2 . Neck dissection is the main curative treatment for head and neck cancer with LN metastasis.…”

“…It has been estimated that LN metastasis accounts for 20-30% of all deaths in patients with malignant tumors of the head and neck region. 1,2 Neck dissection is the main curative treatment for head and neck cancer with LN metastasis. However, LN metastasis remains the main cause of death in elderly and presymptomatic patients for whom surgery is unfeasible or challenging.…”

Management of Contralateral N0 Neck in Pyriform Sinus Carcinoma

“…Patients with squamous cell carcinoma (SCC) of the hypopharynx are often seen at an advanced stage and have a poor prognosis. The poor prognosis can be attributed to late presentation, aggressive local growth, submucosal spread, tendency toward lymphatic spread, and a high incidence of distant metastasis 1–3 …”

Results after radical surgical treatment for advanced carcinoma of hypopharynx

“…It is reported that estimation of synchronous or metachronous malignancy in such tumors is between 10-60% [10,15,[19][20][21]. The presence of synchronous malignancy in these tumors and the multicentricity should be evaluated with advanced radiologic and endoscopic procedures preoperatively.…”