Total pharyngolaryngectomy for squamous cell carcinoma of the hypopharynx: a review.
OBJECTIVE
To evaluate our experience with total pharyngolaryngectomy in the treatment of hypopharyngeal squamous cell carcinoma.


METHODS
Retrospective analysis of consecutively treated patients in an academic otolaryngology, head and neck department.


METHODS
One hundred eighty patients who had total pharyngolaryngectomy performed for hypopharyngeal carcinoma were included in this study. Patients with a history of previous head and neck cancer were excluded. Clinicopathologic parameters were recorded and survival calculated using the Kaplan-Meier method.


RESULTS
One hundred sixty-two (90%) of the patients were male, and the patients had a mean age of 62 years. The majority (91%) of patients had advanced overall clinical stage disease (stage 3,4). Thirty-one (17.8%) and 43 (24%) patients developed locoregional and metastatic disease recurrence, respectively. The 2- and 5-year disease-specific survival rates were 72% and 52%, respectively. Advanced nodal stage, perineural invasion, lymphovascular invasion, and positive margins were predictors of poor survival on univariate analysis, and lymphovascular invasion was an independent prognostic factor on multivariate analysis.


CONCLUSIONS
Surgery and postoperative radiotherapy remains the treatment against which other modalities should be compared for advanced stage hypopharyngeal squamous cell carcinoma.
Bova
Ronaldo
R
Department of Otolaryngology, Head and Neck Surgery, Princess Alexandra Hospital, Brisbane, Australia.
Goh
Raymond
R
Poulson
Michael
M
Coman
William B
WB
D000971:Antineoplastic Combined Chemotherapy Protocols; D002294:Carcinoma, Squamous Cell / Q000556:secondary / Q000601:surgery* / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy; D007825:Laryngectomy / Q000379:methods*; D008175:Lung Neoplasms / Q000556:secondary / Q000601:surgery / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000473:pathology / Q000601:surgery / Q000628:therapy; D010610:Pharyngeal Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy; D010611:Pharyngectomy / Q000379:methods*; D011300:Preoperative Care; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies