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

Primary Surgery vs Chemoradiation Treatment of Advanced-Stage Hypopharyngeal Squamous Cell Carcinoma

“…In fact, most patients treated in this study tended to have more aggressive or radical surgery and underwent multimodality treatment. There have been reports in the literature of local control rates as high as 97% for those treated with more radical surgery in addition to RT, 8 consistent with the data reported herein. Finally, date of death was recorded either from that documented in the electronic medical record or cross-referenced with the US Social Security Index.…”

“…Although many studies report a 30% to 40% survival rate for advanced-stage HP cancer, 4,14 there have been reports of survival as high as 56% to 60% for patients receiving concurrent chemotherapy with RT or multimodality treatment (surgery plus RT or CRT). 8,22 The studies showing higher survival rates tend to be larger. 4,19,22 The present study is among the largest published to evaluate only advanced-stage HP SCC, and the inclusion of patients treated recently with concurrent chemotherapy and RT regimens provides valuable data on modern treatment outcomes.…”

“…While HP SCC represents only 3% to 7% of head and neck cancers, 15,16 approximately 75% to 80% are advanced (stage III or IV) at diagnosis, 8,17 leading to significant therapeutic challenges. Many authors endorse organ preservation, with salvage surgery reserved for local relapse, while other studies suggest that primary surgery may provide superior results.…”

“…[4][5][6] The addition of chemotherapy to definitive RT has also increased in recent years, with large studies demonstrating a small but significant survival benefit. 7 While earlier studies have compared surgical management with definitive RT for HP SCC, [4][5][6][8][9][10][11] IMPORTANCE There is no consensus whether primary surgery followed by either adjuvant radiotherapy (RT) or adjuvant chemoradiation (CRT) or definitive CRT should be the standard treatment approach to advanced-stage hypopharyngeal squamous cell carcinoma (HP SCC).…”

Local Control of Piriform Sinus Cancer Treated by Radiation Therapy Alone

“…The reported series of piriform sinus cancers treated solely with radiation therapy have shown that a local recurrence is the most frequently encountered regrowth (7,9,10). In contrast, patients given multimodality treatment usually succumb to neck node and/or distant metastases (1,(3)(4)(5)11). In order to improve the treatment results of radical radiation therapy, clarification of the prognostic factors for local control by radiation therapy is imperative.…”