A comparison of surgery and radiotherapy in the management of post-cricoid carcinoma.
One hundred and forty-three patients with post-cricoid squamous cell carcinoma are described. Twenty-nine patients (20%) underwent pharyngolaryngoesophagectomy with gastric transposition. Forty-four patients (31%) were treated with radical radiotherapy and 70 (49%) had palliative therapy. Kaplan Meier 5-year survival following surgery was 45% and radiotherapy was 23%. The presence of nodal disease at presentation was the most significant prognostic factor. The 5-year survival of patients undergoing surgery with no palpable lymph node spread at presentation was 63% which compared with 25% following radiotherapy. This difference was statistically significant (P = 0.0153, Logrank test stratified by nodal status). Patients with palpable metastatic nodal spread at presentation had 5-year survivals of 10% and 0% in the surgical and radiotherapy groups respectively. This study demonstrates that patients with post-cricoid carcinoma who present without palpable lymph node spread have a significant improved 5-year survival following surgery when compared with radiotherapy.
Axon
P R
PR
Department of Otolaryngology, Manchester Royal Infirmary, UK.
Woolford
T J
TJ
Hargreaves
S P
SP
Yates
P
P
Birzgalis
A R
AR
Farrington
W T
WT
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D004947:Esophagus / Q000601:surgery; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D007830:Larynx / Q000601:surgery; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D010614:Pharynx / Q000601:surgery; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate