title: Extended voice-sparing surgery in selected pyriform sinus carcinoma: techniques and outcomes.
abstract: BACKGROUND
  Organ-preservation approaches are frequently favored in the treatment of advanced pyriform sinus carcinoma. In selected cases, use of free flaps allows voice-sparing surgery.
  
  
  METHODS
  Thirteen patients underwent conservative extended laryngopharyngectomy. In 11 patients, the resection included the supraglottic larynx, whereas the whole hemilarynx was resected in 2. Reconstruction was achieved with a radial forearm free flap with the palmaris longus tendon. In hemilarynx resection, a costal graft was also used. Functional results were assessed by nasofibroscopy and swallowing videofluoroscopic tests.
  
  
  RESULTS
  At 12 months, no patient was gastrostomy dependent, whereas 1 patient remained tracheostomy dependent. At 1, 3, and 5 years, the locoregional control was 100%, 100%, and 83%; overall survival was 69.4%, 46.3%, and 30.8%; and disease-specific survival was 81.2%, 54.5%, and 36.4%, respectively.
  
  
  CONCLUSIONS
  In selected patients, extended conservative laryngopharyngectomy challenges the oncologic results of organ-preservation protocols and allows a good quality of life.
authors.affiliation: Department of Head and Neck Surgery, Head and Neck Oncology Program, St Luc University Hospital Cancer Center, Catholic University of Louvain, Brussels, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: Hamoir
authors.forename: Juliette
authors.initials: J
authors.lastname: Fievez
authors.forename: Sandra
authors.initials: S
authors.lastname: Schmitz
authors.forename: Dorris
authors.initials: D
authors.lastname: Velasco
authors.forename: Benoît
authors.initials: B
authors.lastname: Lengele
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D058752:Free Tissue Flaps / Q000098:blood supply*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D007825:Laryngectomy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D010610:Pharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D010611:Pharyngectomy / Q000009:adverse effects / Q000379:methods; D011182:Postoperative Care / Q000379:methods; D011379:Prognosis; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014833:Voice Quality