Surgical management of carcinoma of the hypopharynx and cervical esophagus.
Between 1975 and 1988 we observed 169 patients with carcinoma of the cervical esophagus, 85 with a carcinoma involving the hypopharynx and the cervical esophagus, and 27 with a carcinoma of the cervical esophageal region that developed after laryngectomy for laryngeal cancer. The mean age of the patients was 57.5 years (range: 41-73). One hundred and sixty-seven patients underwent surgical exploration (operability rate 59.5%), and in 152 cases the tumor was resected (resectability rate 91.1%). The resection was complete in 129 patients (84.5%) and palliative in 23 (14.5%). In 33 cases a laryngopharyngo-cervical segmental esophagectomy with free intestinal loop transplantation was performed, with an operative mortality of 6.1%. One hundred and three patients underwent laryngo-pharyngo-total esophagectomy, and the digestive tract was reconstructed by means of pharyngo-gastrostomy and pharyngo-colostomy in 85 and 16 cases, with an operative mortality of 12.9% and 18.3%, respectively. Total esophagectomy without laryngectomy was performed in 18 patients with a carcinoma of the distal cervical esophagus who refused laryngectomy, with an hospital mortality of 5.5%. The overall 5-year actuarial survival, excluding the operative mortality, was 15.8%. After complete resection, better results were recorded in patients operated on for carcinoma of the hypopharynx than in patients with carcinoma of the cervical esophagus: the 2-year and 5-year actuarial survival was 59% vs. 26% and 43% vs. 17%, respectively. No patient undergoing palliative resection was alive at the 3-year interval.(ABSTRACT TRUNCATED AT 250 WORDS)
University of Padua, 1st Surgical Department, Padova, Italia.
A
A
Peracchia
R
R
Bardini
A
A
Ruol
A
A
Segalin
C
C
Castoro
M
M
Asolati
E
E
Tiso
D003106:Colon / Q000601:surgery; D004938:Esophageal Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D004947:Esophagus / Q000601:surgery*; D005774:Gastrostomy; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality / Q000601:surgery*; D007583:Jejunum / Q000601:surgery; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery; D007825:Laryngectomy; D008875:Middle Aged; D010166:Palliative Care; D010611:Pharyngectomy; D013524:Surgical Flaps; D015996:Survival Rate