LARYNGOPHARYNGOESOPHAGECTOMY FOR ADVANCED HYPOPHARYNGEAL AND ESOPHAGEAL SQUAMOUS-CELL CARCINOMA - THE YALE EXPERIENCE

The 5-year survival rate for patients with hypopharyngeal squamous cel l carcinoma invading the upper esophagus is below 25% regardless of th erapy. Most patients with advanced disease-unable to eat or breathe-di e within 18 months of diagnosis. Because these patients, on average, h ave a limited time to live, surgical treatment should aim to maximize the quality of remaining life. Essential to this goal are complete tum or removal and rapid return to oral feeding. Furthermore, short hospit al stay and low perioperative morbidity are especially important in th ese patients. We performed total laryngopharyngoesophagectomy (LPE) wi th gastric transposition in 34 patients with hypopharyngeal and cervic al esophageal squamous cell carcinoma. There has been one perioperativ e death (3%) and 1 temporary fistula (3%). No major mediastinal or int rathoracic complication occurred. On average, patients began oral feed ing by postoperative day 10, with return to a full diet and discharge home within 16 days, maximizing both quality and quantity of time rema ining outside the hospital.