Surgical treatment of hypopharyngeal cancer

Abstract

Objectives: This study aims to evaluate our department's approach to the treatment of hypopharyngeal tumors, the features of the tumors, the survival analyses and to present our results in the light of the literature. Patients and Methods: Eighty-one hypopharyngeal tumor patients and four patients with undefined primary origin, those patients with undefined origin have tumors that infiltrate both hypopharynx and cervical esophagus, totally 85 patients (56 males, 29 females; mean age 54.6±13.4 years; range, 23 to 81 years) who underwent surgical treatment, were included in this study. Demographic data, tumor characteristics, and treatment protocols were recorded retrospectively. Results: Patients were classified on the primary subsite of the hypopharynx: 51% originated from the sinus piriformis, 29% from the postcricoid area, 15% from the posterior wall of the pharynx and only 5% from the cervical esophagus. The relationship between sex and hypopharyngeal subsite was statistically significant (p<0.001); postcricoid tumors were more prominent in female patients. Also, patients with a history of tobacco use had a tendency for tumors originating from the piriform sinus (p<0.001). Additionally, highly significant differences were revealed between clinical and pathological T and N staging (p<0.001). Estimated 60-month survival rate was 45%. Conclusion: The majority of patients in the study group were not old-aged or alcohol consumers; particularly none of the female patients had any bad habit as a predisposing factor suggested in the etiology. The relationships between tumor site and smoking show that if the campaign against smoking is successful, the rate of sinus piriformis cancer will decrease. For a significant number of patients, primary surgical reconstruction was possible, which shortens postoperative recovery time and accelerates postoperative adjuvant therapy. Therefore, survival rates were found to be high.

Total Laryngectomy—Still Cutting-Edge?

“…Hypopharyngeal cancer has the same risk factors but, with an incidence of about 1/100,000, is considerably less common than laryngeal cancer. The lack of symptoms until a later stage and the resultant late diagnosis, together with early lymphatic spread, add up to a poorer prognosis [9,10]. It is well known that cigarette smoke increases the relative risk of developing a supraglottic tumour, while alcohol promotes increases the relative risk of developing a supraglottic tumour, while alcohol promotes hypopharyngeal tumours [11,12].…”