[Surgical management of aged patients with hypopharyngeal carcinoma and preservation of laryngeal function].
OBJECTIVE
The prolongation of life expectancy results in an increasing number of aged patients with hypopharyngeal carcinoma who have poor surgical tolerance because of degenerative organ functions. This study was to explore the surgical methods and preservation of laryngeal function for aged patients with hypopharyngeal carcinoma.


METHODS
Clinical data of 84 patients with hypopharyngeal carcinoma who aged above 60 years, treated from 1996 to 2001, were retrospectively reviewed. Of the 84 cases, 68 were originated from pyriform sinus, 5 from postcricoid area, 11 from posterior pharyngeal wall; 57 patients received partial laryngectomy with laryngeal function preservation, 27 received total laryngectomy. Kaplan-Meier method and log-rank test were used to evaluate the survival rates.


RESULTS
The overall 3- and 5-year survival rates were 60.7% and 53.3%, respectively. The 3- and 5-year survival rates of laryngeal function preservation group was not significantly different from those of total laryngectomy group (63.2% vs. 55.6%, P = 0.37; 56.7% vs. 46.3%, P > 0.05). In laryngeal function preservation group, 39 (68.4%) had all functions preserved (voice, respiration, and deglutition), and 18 (31.6%) partially preserved (voice and deglutition).


CONCLUSIONS
It is safe and effective to treat aged hypopharyngeal carcinoma patients with surgery, and is possible to preserve laryngeal function in T3-4 stage aged patients who have no involvement of contralateral larynx, no invasion to esophagus, and no deglutition difficulty.
Zhang
Dao-Gong
DG
Department of Otolhryngology, Qilu Hospital, Shandong University, Jinan, Shandong, 250012, PR China. zhangdaogong1978@163.com
Luan
Xin-Yong
XY
Pan
Xin-Liang
XL
Xie
Guang
G
D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D003679:Deglutition; D005500:Follow-Up Studies; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D007013:Hypopharynx / Q000601:surgery; D007825:Laryngectomy / Q000379:methods*; D007830:Larynx / Q000503:physiopathology* / Q000601:surgery; D008875:Middle Aged; D037981:Neck Dissection; D009367:Neoplasm Staging; D010611:Pharyngectomy / Q000379:methods; D012189:Retrospective Studies; D015996:Survival Rate