Hypopharyngeal squamous cell carcinoma - Treatment results in 138 consecutively admitted patients

The aim of this study was to evaluate the results of the initial and salvag e treatment for hypopharyngeal carcinoma. The study was conducted in 1963 t o 1991 and included 138 patients (38 females (28%) and 100 males (73%)). Mo st of the tumours originated in the piriform sinus (86%). Tumour stage dist ribution was Ti: 20%,, T2: 27%, T3: 37% and T4: 17% and nodal stage distrib ution was NO: 45%, N1: 25%, N2: 10%, and N3: 20%. Primary treatment was del ivered with curative intent in 124 out of 138 cases (90%). Treatment failur e was noted in 98 patients, with 55% recurrence in T-position, 39% in N-pos ition, and 14% at distant metastases sites. Salvage surgery was successful in 9 out of 32 patients. The overall 5-year locoregional tumour control, ca use-specific and overall survival rates were 20%, 25% and 19%, respectively . Univariate actuarial analysis showed that T- and N-stage, clinical stage, tumour size and well-differentiated tumours were significant prognostic pa rameters. A Cox multivariate analysis showed that only the T- and N-stages were independent prognostic factors. In conclusion, the prognosis for advan ced hypopharyngeal carcinoma is extremely poor and the meagre results with conventional radiotherapy alone indicate that other treatment modalities sh ould be introduced in the management of this disease.