title: Results of total laryngectomy as treatment for locally advanced hypopharyngeal cancer.
abstract: OBJECTIVE
  Total laryngectomy (TL), with eventual postoperative radiotherapy, has proven to be effective in treating cases of locally advanced hypopharyngeal cancer. The aim of this study was to analyse the oncological outcomes of this procedure in patients with hypopharyngeal cancer classified T3 and T4.
  
  
  METHODS
  We studied 59 patients (33 T3 and 26 T4a) with primary squamous cell carcinoma of the hypopharynx treated with TL from 1998 to 2012.
  
  
  RESULTS
  Mean age was 61 years with a male predominance (96.6%). All the patients were smokers and 96% consumed alcohol. Unilateral selective neck dissection (ND) was performed in 12 patients, unilateral radical ND in 11 patients, bilateral selective ND in 20 patients and radical ND plus selective ND in 14 patients. 66% of the patients received postoperative radiotherapy. Lymph node metastases occurred in 81% of the patients and extranodal invasion in 56% of them. 29% of the patients had loco-regional recurrence, 17% developed distant metastases, and 25% a second primary tumour. The 5-year disease-specific survival was 46%.
  
  
  CONCLUSIONS
  TL extended to pharynx (with eventual postoperative radiotherapy) offers good oncological results in terms of loco-regional control and survival in locally advanced hypopharyngeal cancer, so organ preservation protocols should achieve similar oncological results to those shown by TL.
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España.
authors.forename: Patricia
authors.initials: P
authors.lastname: García-Cabo Herrero
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España.
authors.forename: Laura
authors.initials: L
authors.lastname: Fernández-Vañes
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España; Instituto Universitario de Oncología del Principado de Asturias, Universidad de Oviedo, Oviedo, España; Ciberonc, España.
authors.forename: Fernando
authors.initials: F
authors.lastname: López Álvarez
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España; Instituto Universitario de Oncología del Principado de Asturias, Universidad de Oviedo, Oviedo, España; Ciberonc, España.
authors.forename: César
authors.initials: C
authors.lastname: Álvarez Marcos
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España; Instituto Universitario de Oncología del Principado de Asturias, Universidad de Oviedo, Oviedo, España; Ciberonc, España.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Llorente
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España; Instituto Universitario de Oncología del Principado de Asturias, Universidad de Oviedo, Oviedo, España; Ciberonc, España. Electronic address: juanpablo.rodrigo@sespa.es.
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Rodrigo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy / Q000601:surgery*; D003131:Combined Modality Therapy; D015897:Comorbidity; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D007825:Laryngectomy / Q000379:methods*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D016609:Neoplasms, Second Primary / Q000453:epidemiology; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Cáncer de hipofaringe; Hypopharyngeal cancer; Laringectomía total; Organ preservation; Preservación de órgano; Radioterapia; Radiotherapy; Total laryngectomy