Organ preservation surgery for advanced hypopharyngeal cancer.
CONCLUSIONS
Organ preservation surgery with partial pharyngectomy preserving the larynx is feasible for the treatment of advanced hypopharyngeal cancer with comparable local control and preservation of function.


OBJECTIVE
To examine the feasibility and therapeutic effects of organ preservation surgery for advanced hypopharyngeal cancer.


METHODS
Fourteen patients with stage III/IV hypopharyngeal cancer were treated by partial pharyngectomy with or without partial laryngectomy to preserve the larynx. Ten cases were T1/2 primary while four cases had T3/4 tumors. Reconstruction of the pharyngolarynx was completed by primary mucosal suture in six, while free forearm flap was used in eight cases. Induction chemotherapy was administered for six cases including three with T3/4 tumors.


RESULTS
Five-year overall survival and disease-specific survival rates were 57.1% and 66.7%, respectively. The 5-year locoregional control rate was 66.7% and the larynx preservation rate was 100%. No patients presented with local recurrence at the pharyngolaryngeal segment, while two cases showed nodal recurrence, from which they died. Tracheal stoma was closed in 9 of 14 cases. Vocal function was excellent in five cases, moderate in five, and poor in three. Swallowing function was excellent to moderate in eight cases and poor in six.
Hirano
Shigeru
S
Department of Otolaryngology Head and Neck Surgery, Kyoto University, Kyoto, Japan. hirano@ent.kuhp.kyoto-u.ac.jp
Tateya
Ichiro
I
Kitamura
Morimasa
M
Kada
Shinpei
S
Ishikawa
Seiji
S
Kanda
Tomoko
T
Tanaka
Shinzo
S
Ito
Juichi
J
D000368:Aged; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009367:Neoplasm Staging; D010611:Pharyngectomy; D012189:Retrospective Studies; D013524:Surgical Flaps; D015996:Survival Rate; D016896:Treatment Outcome