title: Systematic review of carcinoma arising in pharyngeal diverticula: a 112-year analysis.
abstract: BACKGROUND
  Carcinoma is a rare complication of pharyngeal diverticula. There is a paucity of information about its incidence, presentation, management, and treatment outcomes. A systematic review and analysis of all reported cases has been carried out.
  
  
  METHODS
  A comprehensive literature search for pharyngeal diverticula carcinoma was performed from 1896 to 2008. Descriptive analyses were carried out by analyzing the absolute and relative frequencies. Comparison of groups was illustrated with Kaplan-Meier curves and tested statistically using the log-rank test. A cohort of 56 patients with benign pharyngeal diverticula was selected for comparison with the accumulated cohort of pharyngeal diverticula carcinoma, and a Fisher's exact test was carried out on the extracted clinical characteristics of this cohort to evaluate for differences between benign and malignant pharyngeal diverticula.
  
  
  RESULTS
  Forty-three articles reporting 60 cases satisfied the inclusion criteria. The mean age at presentation was 68.8 years (SD = 9.8 years). Five-year cancer-specific survival (CSS) rates for patients who underwent excision alone, excision + postoperative radiotherapy (PORT), and radiotherapy alone were 0.74 versus 0.63 versus 0.0, respectively (p = .39). Five-year CSS rates of patients <65 versus ≥65 years were 0.43 versus 0.78, respectively (p = .046).
  
  
  CONCLUSIONS
  Irregular symptoms in benign diverticula should raise suspicion of malignancy. Management consists of surgical excision ± PORT. © 2014 Wiley Periodicals, Inc. Head Neck 36: 1368-1375, 2014.
authors.affiliation: Head and Neck Unit, Royal Marsden Hospital, Fulham Road, London, United Kingdom.
authors.forename: Afroze S
authors.initials: AS
authors.lastname: Khan
authors.forename: Raghav C
authors.initials: RC
authors.lastname: Dwivedi
authors.forename: Zishan
authors.initials: Z
authors.lastname: Sheikh
authors.forename: Shahnawaz
authors.initials: S
authors.lastname: Khan
authors.forename: Ravi C
authors.initials: RC
authors.lastname: Dwivedi
authors.forename: Namita
authors.initials: N
authors.lastname: Kanwar
authors.forename: Nishant
authors.initials: N
authors.lastname: Agrawal
authors.forename: Mohammed Sultan
authors.initials: MS
authors.lastname: Ui Hassan
authors.forename: Rehan
authors.initials: R
authors.lastname: Kazi
authors.forename: Peter
authors.initials: P
authors.lastname: Rhys-Evans
mesh_terms: D002277:Carcinoma / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D010610:Pharyngeal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D016672:Zenker Diverticulum
keywords: Zenker's diverticulum; carcinoma; head and neck cancers; pharyngeal diverticula