Conservation Surgery for Hypopharyngeal Cancer

Choi, Geon; Oh, Seung Chul; Ko, Tae Ok; Park, Jae Hyung; Jung, Kwang Yoon; Choi, Jong Ouck

Abstract

BACKGROUND: Hypopharyngeal cancer was known to be more aggressive, extensive, and clinically malignant than laryngeal cancer, not generally considered suitable for conservative surgery in the past. Ogura, et al(1960) reported little was gained by sacrificing the entire larynx in many cases of hypopharyngeal cancer.
OBJECTIVE
Present study was undertaken to evaluate the complications and results of conservation surgery for hypopharyngeal cancer.
MATERIALS AND METHODS
A retrospective review of six patients treated by conservation surgery for early hypopharyngeal cancer was performed. The patients had squamous cell carcinomas at various subsites, including the medial wall of piriform sinus(three patients), posterior hypopharyngeal wall(two patients), and lateral wall of hypopharynx(one patient). Stage of primary tumor showed T1 of 4 patients and T2 of 2 patients. Partial laryngopharyngectomy was performed for three patients with medial wall of piriform sinus, median labiomandibular approach for two patients with posterior wall of hypopharynx and partial pharyngectomy via lateral pharyngotomy for a patient with lateral wall of piriform sinus. Four patients with cervical lymph node metastasis underwent radical neck dissection. Postoperative radiation therapy were done for all patient with 5500 to 6700 cGy.
RESULTS
Complications of surgical procedure showed two patients with aspiration and a patient with pharyngocutaneous fistula. Despite of shorterm follow-up period all but one patient showed no evidence of disease. A patient is alive with distant metastasis.
CONCLUSION
Conservation surgery seems to be effective surgical method to control the early hypopharyngeal cancer.