Article
Comprehensive treatment of 352 cases with hypopharyngeal cancer
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Published: | April 4, 2012 |
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Objective: To review the experience of different surgical construction methods and comprehensive treatments for hypopharyngeal cancer.
Methods: 352 cases with hypopharyngeal cancer were retrospectively reviewed from 1999 to 2005. All the tumors originated from the pyriform sinus (272) , posterior pharyngealwall (61), postcricoid area (19). 241 cases were surgically treated with laryngeal functions preserved and 111 cases without laryngeal functions preserved. All the patients received modified neck dissection. Pharyngoesophageal defect reconstruction methods included: direct suture, pectoralis major musculocutaneous flap, pectoralis major musculocutaneous flap combined with the split graft, stomach pulling-up, colon interposition. All patients received radiotherapy postoperatively.
Results: The overall 3 and 5 year survival rates were 65.1% (229/352) and 53.6% (142/265), respectively. The 3 and 5 year survival rates in functionally preserved group were 68.0% (164/241) and 59.7% (114/191), respectively, while in non-functionally preserved group were 58.6% (65/111) and 37.8% (28/74), respectively. Laryngeal functions (voice, respiration and deglutition) were completely restored in 169 patients and partially restored (voice and deglutition) in 72 patients.
Conclusions: Combined surgery and radiotherapy was the best choice for hypopharyngeal cancer. The preservation of laryngeal function and the laryngeal and pharyngeal reconstruction are based on the premise that the tumor was excised completely.