[T1-T2 NO hypopharyngeal cancers treated with surgery alone. A GETTEC study (French Neck Study Group)].
OBJECTIVE
Consider whether surgery alone in the treatment of early cancers of the hypopharynx can give identical or better results in terms of survival and local control than radiotherapy.


METHODS
Forty-five patients were operated on during the years 1991-2004. Surgical treatment consisted in a resection by the transoral approach in four patients and 41 patients had a partial pharyngolaryngectomy. An elective neck dissection was performed on 43 patients.


RESULTS
The 1-, 3-, and 5-year overall survival rates were 100, 95, and 75%. The 1-, 3-, and 5-year locoregional control rates were 93, 88, and 82% and were influenced by the presence of dysplasia on surgical margins (p=0.027). The oncological occurrences observed were five local recurrences, two nodal recurrences, ten second primary cancers, and two metastases. Five locoregional failures out of seven were controlled after a second treatment.


CONCLUSIONS
Surgery alone gives completely satisfactory results in terms of survival and locoregional control. In case of recurrence, this makes it possible to operate on patients in nonirradiated areas with lower morbidity and mortality and better results. These results must be confirmed by a randomized trial.
Foucher
M
M
Service d'ORL, centre hospitalier Lyon-Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France.
Poissonnet
G
G
Rame
J-P
JP
Toussaint
B
B
Védrine
P-O
PO
Dassonville
O
O
de Raucourt
D
D
Cosmidis
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D005260:Female; D005602:France; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods; D009367:Neoplasm Staging; D010611:Pharyngectomy / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D013515:Surgery, Oral / Q000379:methods; D016019:Survival Analysis; D016896:Treatment Outcome