Clin Exp Otorhinolaryngol.  2011 Mar;4(1):44-48.

Larynx-Preserving Partial Pharyngectomy via Lateral Pharyngotomy for the Treatment of Small (T1~2) Hypopharyngeal Squamous Cell Carcinoma

Affiliations
  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University School of Medicine, Seoul, Korea.
  • 2Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea.
  • 3Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea. eunchangmd@yuhs.ac

Abstract


OBJECTIVES
To evaluate the oncologic and functional results of larynx-preserving partial pharyngectomy (LPP) via lateral pharyngotomy approach as a primary treatment for small (T1 or T2) hypopharyngeal squamous cell carcinoma (HPSCC).
METHODS
We performed a retrospective review of 23 patients who underwent LPP through lateral pharyngotomy approach for small HPSCC at the our department between January 1991 and June 2007. Fourteen (61%) patients had adjuvant postoperative radiotherapy.
RESULTS
The 2-years and 5-years disease specific survival rate was 77% and 61%, respectively. Nine patients (39%) had tumor recurrence. The most common pattern of recurrence was isolated distant failure (n=4, 44%) followed by local (n=2, 22%) and loco-regional (n=3, 34%) recurrence. The ultimate cure rate of the primary tumor was 87% (20 of 23). Twenty-two of the 23 patients (95%) could be decannulated, tolerate an oral diet, and had acceptable postoperative phonatory function.
CONCLUSION
LPP via lateral pharyngotomy approach appears to be a feasible procedure for selected small HPSCC patients in terms of both oncologic and functional outcomes.

Keyword

Hypopharyngeal neoplasm; Pharyngectomy; Lateral pharyngotomy; Adjuvant radiotherapy

MeSH Terms

Carcinoma, Squamous Cell
Diet
Humans
Hypopharyngeal Neoplasms
Pharyngectomy
Radiotherapy, Adjuvant
Recurrence
Retrospective Studies
Survival Rate

Figure

  • Fig. 1 Five-years survival rate of all patients.


Reference

1. Berrino F, Gatta G. Variation in survival of patients with head and neck cancer in Europe by the site of origin of the tumours. Eur J Cancer. 1998; 12. 01. 34(14):2154–2161.
Article
2. Hoffman HT, Karnell LH, Shah JP, Ariyan S, Brown GS, Fee WE, et al. Hypopharyngeal cancer patient care evaluation. Laryngoscope. 1997; 8. 107(8):1005–1017. PMID: 9260999.
Article
3. Kraus DH, Zelefsky MJ, Brock HA, Huo J, Harrison LB, Shah JP. Combined surgery and radiation therapy for squamous cell carcinoma of the hypopharynx. Otolaryngol Head Neck Surg. 1997; 6. 116(6 Pt 1):637–641. PMID: 9215375.
Article
4. Nakamura K, Shioyama Y, Kawashima M, Saito Y, Nakamura N, Nakata K, et al. Multi-institutional analysis of early squamous cell carcinoma of the hypopharynx treated with radical radiotherapy. Int J Radiat Oncol Biol Phys. 2006; 7. 15. 65(4):1045–1050. PMID: 16682142.
Article
5. Amdur RJ, Mendenhall WM, Stringer SP, Villaret DB, Cassisi NJ. Organ preservation with radiotherapy for T1-T2 carcinoma of the pyriform sinus. Head Neck. 2001; 5. 23(5):353–362. PMID: 11295808.
Article
6. Dirix P, Nuyts S, Van den Bogaert W. Radiation-induced xerostomia in patients with head and neck cancer: a literature review. Cancer. 2006; 12. 01. 107(11):2525–2534. PMID: 17078052.
7. Trotti A, Bellm LA, Epstein JB, Frame D, Fuchs HJ, Gwede CK, et al. Mucositis incidence, severity and associated outcomes in patients with head and neck cancer receiving radiotherapy with or without chemotherapy: a systematic literature review. Radiother Oncol. 2003; 3. 66(3):253–262. PMID: 12742264.
Article
8. Jones AS. The management of early hypopharyngeal cancer: primary radiotherapy and salvage surgery. Clin Otolaryngol Allied Sci. 1992; 12. 17(6):545–549. PMID: 1493635.
Article
9. Ogura JH, Watson RK, Jurema AA. Partial pharyngectomy and neck dissection for posterior hypopharyngeal cancer. Immediate reconstruction with preservation of voice. Laryngoscope. 1960; 11. 70(11):1523–1534. PMID: 13730472.
10. Cocek A, Prucha I, Hahn A. Lateral pharyngotomy extended by resection of the mandibular angle-an alternative approach to the surgical treatment of oropharyngeal (tonsillar) cancers. Acta Otolaryngol. 2009; 3. 129(3):318–323. PMID: 18607919.
11. Martin A, Jackel MC, Christiansen H, Mahmoodzada M, Kron M, Steiner W. Organ preserving transoral laser microsurgery for cancer of the hypopharynx. Laryngoscope. 2008; 3. 118(3):398–402. PMID: 18091337.
Article
12. Park YM, Lee WJ, Lee JG, Lee WS, Choi EC, Chung SM, Kim SH. Transoral robotic surgery (TORS) in laryngeal and hypopharyngeal cancer. J Laparoendosc Adv Surg Tech A. 2009; 6. 19(3):361–368. PMID: 19405798.
Article
13. Shimizu Y, Yamamoto J, Kato M, Yoshida T, Hirota J, Ono Y, et al. Endoscopic submucosal dissection for treatment of early stage hypopharyngeal carcinoma. Gastrointest Endosc. 2006; 8. 64(2):255–259. PMID: 16860078.
Article
14. Byers RM. Anatomic correlates in head and neck surgery. The lateral pharyngotomy. Head Neck. 1994; Sep–Oct. 16(5):460–462. PMID: 7960746.
Article
15. Kania R, Hans S, Garcia D, Brasnu D, De Mones E, Laccourreye O. Supracricoid hemilaryngopharyngectomy in patients with invasive squamous cell carcinoma of the pyriform sinus. Part II: Incidence and consequences of local recurrence. Ann Otol Rhinol Laryngol. 2005; 2. 114(2):95–104. PMID: 15757187.
16. Czaja JM, Gluckman JL. Surgical management of early-stage hypopharyngeal carcinoma. Ann Otol Rhinol Laryngol. 1997; 11. 106(11):909–913. PMID: 9373080.
Article
17. Eckel HE, Staar S, Volling P, Sittel C, Damm M, Jungehuelsing M. Surgical treatment for hypopharynx carcinoma: feasibility, mortality, and results. Otolaryngol Head Neck Surg. 2001; 5. 124(5):561–569. PMID: 11337663.
Article
18. Frank JL, Garb JL, Kay S, McClish DK, Bethke KP, Lind DS, et al. Postoperative radiotherapy improves survival in squamous cell carcinoma of the hypopharynx. Am J Surg. 1994; 11. 168(5):476–480. PMID: 7977979.
Article
19. Garavello W, Ciardo A, Spreafico R, Gaini RM. Risk factors for distant metastases in head and neck squamous cell carcinoma. Arch Otolaryngol Head Neck Surg. 2006; 7. 132(7):762–766. PMID: 16847186.
Article
20. Leon X, Quer M, Orús C, del Prado Venegas M, Lopez M. Distant metastases in head and neck cancer patients who achieved loco-regional control. Head Neck. 2000; 10. 22(7):680–686. PMID: 11002323.
Article
21. Wang T, Li X, Lu Y, Yu Z. Preservation of laryngeal function in treatment of hypopharyngeal carcinoma. Chin Med J (Engl). 2002; 6. 115(6):892–896. PMID: 12123560.
22. Goepfert H, Lindberg RD, Jesse RH. Combined laryngeal conservation surgery and irradiation: can we expand the indications for conservation therapy? Otolaryngol Head Neck Surg. 1981; Nov–Dec. 89(6):974–978. PMID: 6801601.
Article
23. Laccourreye O, Ishoo E, de Mones E, Garcia D, Kania R, Hans S. Supracricoid hemilaryngopharyngectomy in patients with invasive squamous cell carcinoma of the pyriform sinus. Part I: Technique, complications, and long-term functional outcome. Ann Otol Rhinol Laryngol. 2005; 1. 114(1 Pt 1):25–34. PMID: 15697159.
24. Holsinger FC, Motamed M, Garcia D, Brasnu D, Ménard M, Laccourreye O. Resection of selected invasive squamous cell carcinoma of the pyriform sinus by means of the lateral pharyngotomy approach: the partial lateral pharyngectomy. Head Neck. 2006; 8. 28(8):705–711. PMID: 16786602.
Article
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