title: Chemoradiation therapy with or without salvage surgery for early squamous cell carcinoma of the hypopharynx.
abstract: OBJECTIVE
  Early squamous cell carcinoma of the hypopharynx is a rare clinical entity. Our objective was to analyze the outcome of patients with early hypopharyngeal cancer treated with curative radiotherapy or the combination of preoperative radiotherapy with surgery.
  
  
  METHODS
  Forty-three patients with Stage I-II hypopharyngeal cancer were initially treated with 30-40 Gy of irradiation with or without chemotherapy. Thirty-two patients (74.4%) who demonstrated a complete response continued to receive further radiotherapy, with a median total dose of 61.2 Gy. Eleven other patients (25.6%) received surgery.
  
  
  RESULTS
  Local control with laryngeal voice preservation was achieved in 8 (88.9%) of 9 patients with Stage I disease, and in 23 (67.6%) of 34 patients with Stage II disease. The overall and disease-specific 5-year survival rates for all patients were 70.4% and 89.5%, respectively. The disease-specific survival rates according to the T-category were 100% for patients with T1 disease and 87.2% for patients with T2 disease (p = 0.32). Twenty patients (46.5%) had synchronous or metachronous cancers. Four patients died of hypopharyngeal cancer, and 5 died of second-primary esophageal cancer.
  
  
  CONCLUSIONS
  A majority of patients with early hypopharyngeal cancer was curable. However, second malignancies influenced the overall outcome of patients with early hypopharyngeal cancer.
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. nakam@radiol.med.kyushu-u.ac.jp
authors.forename: Katsumasa
authors.initials: K
authors.lastname: Nakamura
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Shioyama
authors.forename: Tomonari
authors.initials: T
authors.lastname: Sasaki
authors.forename: Saiji
authors.initials: S
authors.lastname: Ohga
authors.forename: Madoka
authors.initials: M
authors.lastname: Saku
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Urashima
authors.forename: Tadamasa
authors.initials: T
authors.lastname: Yoshitake
authors.forename: Torahiko
authors.initials: T
authors.lastname: Nakashima
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Kuratomi
authors.forename: Shizuo
authors.initials: S
authors.lastname: Komune
authors.forename: Hiromi
authors.initials: H
authors.lastname: Terashima
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Honda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery*; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary; D010611:Pharyngectomy; D011879:Radiotherapy Dosage; D016879:Salvage Therapy; D015996:Survival Rate