gms | German Medical Science

Introduction: authors report function sparing surgical intervention for early tumors (T1, T2) of the piriform sinus as a primary treatment with neck dissection between 2001-2011. Surgical technique of supraglottic hemi-pharyngolaryngectomy, oncological and functional results are demonstrated.

Methods: 51 patients were retrospectively reviewed who underwent supraglottic hemipharyngo-laryngectomy with neck dissection for hypopharyngeal squamous cell carcinoma and neck metastasis. Our surgical method involved unilateral neck incision, prelaryngeal muscles are unilateraly dissected and resection the lateral part of the thyroid cartilage, tumor of infiltrated pyriform sinus and part of the larynx. Perichondrium of the resected thyroid cartilage was preserved for reconstruction of the neopharynx beside pharyngeal mucosa and prelaryngeal muscles.

30 patients got additional postoperative radiation therapy and 10 patients chemotherapy.

Results: 2 years survival of 51 patients after salvage treatments is 59% (30/51 patients), but 3 years survival is 37%. Salvage therapies were performed: 8 laryngectomies with partial pharynx resection (16%) for local recurrence, 9 sRND (18%) for late neck metastasis. In 5 patients second primary tumor (20%) was observed, 2 patients (4%) had distant metastasis.

Deglutition was altering, but acceptable, voice function was preserved in all patients.

Conclusions: supraglottic hemipharyngo-laryngectomy with neck dissection and postoperative radiation therapy represents a method preserving laryngeal function and providing acceptable quality of life – swallowing and voice – in selective cases of early piriform sinus cancer, although local and regional recurrences result in a relative poor prognosis.

Der Erstautor gibt keinen Interessenkonflikt an.