title: Therapeutic Management of Pyriform Sinus Cancer.
abstract: Objective To analyze the survival rate of a nonselected pyriform sinus cancer population. Study Design Case series with chart review. Setting University hospital. Subjects and Methods A total of 122 patients were included in this study covering the 2002-2008 period. All patients had squamous cell carcinoma originating from the pyriform sinus. Survival and prognostic factors were analyzed. Results The 3- and 5-year overall survival rates were 39.7% and 2.4%, respectively. The 3- and 5-year survival rates without recurrence were 34% and 27%, respectively. The median survival rates by UICC stage were as follows: stage 1 and 2 patients, 60 months; stage 3, 40 months; stage 4, 19 months. Stage 4 patients had a lower median survival rate than other stages ( P = .039). The 5-year survival rate was 46% for patients having T3-T4 operable cancers treated by surgery vs 45% for patients treated by laryngeal conservation protocol (not significant). The 5-year survival rate for patients having nonoperable T4 cancers was 17.2%. The 3- and 5-year overall survival rates of N0 patients was significantly higher than N1 patients ( P = .042). N2 and N3 patients had 100% 5-year mortality. Conclusion This study showed that overall survival and therapeutic management depend on the initial stage of pyriform sinus cancer, notably on the N status. In particular, nonoperable T4 pyriform sinus cancer and N2 and N3 patients had a very poor prognosis. A laryngeal conservation protocol seemed as effective as surgical management in terms of survival.
authors.affiliation: 1 ENT and Head and Neck Surgery Department, University Hospital of Amiens, Amiens, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Donnadieu
authors.affiliation: 1 ENT and Head and Neck Surgery Department, University Hospital of Amiens, Amiens, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Klopp-Dutote
authors.affiliation: 1 ENT and Head and Neck Surgery Department, University Hospital of Amiens, Amiens, France.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Biet-Hornstein
authors.affiliation: 1 ENT and Head and Neck Surgery Department, University Hospital of Amiens, Amiens, France.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Strunski
authors.affiliation: 2 ENT and Head and Neck Surgery Department, University Hospital of Lille, Lille, France.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Mortuaire
authors.affiliation: 1 ENT and Head and Neck Surgery Department, University Hospital of Amiens, Amiens, France.
authors.forename: Cyril
authors.initials: C
authors.lastname: Page
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D056144:Pyriform Sinus; D012189:Retrospective Studies; D015996:Survival Rate
keywords: head and neck squamous cell carcinoma; hypopharyngeal cancer; pyriform sinus cancer