Tumor Depth as a Predictor of Lymph Node Metastasis of Supraglottic and Hypopharyngeal Cancers
Masayuki TomifujiYorihisa ImanishiKoji ArakiTaku YamashitaSohei YamamotoKaori KameyamaAkihiro Shiotani
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Surgical oncology
Hypopharyngeal cancer
Surgical oncology
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Surgical oncology
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Surgical oncology
Clinical Oncology
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To investigate the preservation of laryngeal function for the patients with hypopharyngeal cancer.Two hundred and ninety-three cases of hypopharyngeal cancer with surgical management were reviewed retrospectively, and 222 cases were originated from pyriform sinus, 13 from post-cricoid, and 21 from posterior pharyngeal wall. Radiotherapy (37 cases), operation only (56 cases) and the combined treatment (operation plus radiation or chemotherapy, 200 cases) were adopted. 159 cases were treated with function preserved laryngectomy and 97 with total laryngectomy.The 5 year survival rates of patient with laryngeal function preserved and no laryngeal function preserved were 51.3%, 47.6% (for stage III); 40.4%, 43.3% (for stage IV), respectively. There were no significant differences in 5-year survival between the functionally preserved group and no functioned group (P > 0.05). The analysis of survival rates revealed a significant difference between combined therapy and radiotherapy.There is no significant difference between the survive rates of function preserved and non-preserved groups. Conservation laryngectomy improves the quality of patient's life, and combined therapy is the best choice for hypopharyngeal cancer.
Hypopharyngeal cancer
Pyriform Sinus
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Background: The extra-capsular spread (ECS) of lymph node metastasis (LNM) is a hallmark of aggressive primary tumor phenotype in head and neck cancer (HNC); however, the factors influencing ECS are poorly understood. Patients and Methods: This was a retrospective study, including 190 cases of oral tongue cancer (OTC), 148 cases of oropharyngeal cancer (OPC) (118 HPV-positive and 30 HPV-negative), and 100 cases of hypopharyngeal cancer (HPC). Tumor dimension, tumor biological variables (lymphovascular/perineural invasion and histologic grade), and LNM variables (LNM number and size) were analyzed according to the presence of ECS using multivariable logistic regression and receiver operating characteristic (ROC) curve analyses. Results: LNM variables were significant factors for ECS in all subsites of HNC (p < 0.05), except HPV-positive OPC. In OTC, tumor dimensional variables were significantly related to ECS (p < 0.01). Meanwhile, in OPC and HPC, neither the primary tumor dimension nor the T status were significant factors for ECS occurrence. The predictability of ECS by ROC curve using multiple variables was 0.819 [95% confidence interval: 0.759–0.878] in OTC, 0.687 [0.559–0.815] in HPV-positive OPC, 0.823 [0.642–1.000] in HPV-negative OPC, and 0.907 [0.841–0.973] in HPC. Conclusion: LNM variables were correlated with ECS occurrence for most HNC subsites, and site-dependent primary tumor characteristics might contribute differentially to the ECS development of LNM in HNC.
Hypopharyngeal cancer
Perineural invasion
Primary tumor
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Surgical oncology
Precision oncology
Surgical procedures
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Surgical oncology
Hypopharyngeal cancer
Cancer surgery
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Although the treatment plan for laryngeal and hypopharyngeal cancers is already well established, the prognosis for hypopharyngeal cancer is still poor. Our purpose in the present report is to provide some hints for the improvement of the prognosis for these diseases.In our department, from March 1986 to August 1994, 62 patients with laryngeal cancer and 21 with hypopharyngeal cancer underwent initial treatment. In the 62 patients with laryngeal cancer, recurrence was observed in 13 cases; and in the 21 with hypopharyngeal cancer, recurrence was observed in 7 cases.Five patients who had a recurrence in the larynx were saved with a second radical operation. On the other hand, distant metastasis was observed in 4 cases, and these patients died from their metastasis.In the 7 patients with a recurrensce of hypopharyngeal cancer, 3 cases were observed in the primary region, 2 were in the cervical region, and 2 were in distant organs.In the department, laryngeal cancer is first treated with radiotherapy to preserve the voice, and hypopharyngeal cancer is first treated with a radical operation including preoperative chemotherapy and postoperative radiotherapy for improvement of the prognosis.
Hypopharyngeal cancer
Distant metastasis
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Patients with hypopharyngeal cancer are well known to often have multiple primary cancers, including, in particular, esophageal cancer. Radiotherapy is not suitable for the treatment of hypopharyngeal cancer if the patient has already received irradiation for esophageal cancer. Therefore, we regard partial pharyngectomy as a very important strategy for the purpose of laryngeal preservation in patients with hypopharyngeal cancer.
Hypopharyngeal cancer
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Hypopharyngeal cancer is a common malignant tumor of otorhinolaryngology,which is considered to be one of the head and neck tumor with poor prognosis.Hypopharyngeal cancer is insidious in its onset and progresses rapidly,leading to significant delay in diagnosis; Most patients are in late stage at diagnosis. Surgery combined with chemoradiotherapy is the main treatment of locally advanced hypopharyngeal cancer. Biological treatment has drawn more and more attentions. In this paper,we summarize the progress in the treatment of locally advanced hypopharyngeal cancer.
Hypopharyngeal cancer
Chemoradiotherapy
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