Surgical treatment for hypopharynx carcinoma: Feasibility, mortality, and results

This study seeks to evaluate treatment modalities, mortality after surgery survival, and local control rates for a consecutive cohort of patients with cancer of the hypopharynx treated according to a prospective protocol that favors surgery as an initial approach to the disease. The charts of 228 co nsecutive patients with previously untreated hypopharyngeal squamous cell c arcinoma were reviewed. Outcome measures (overall survival, disease specifi c survival, and local control) were calculated using the Kaplan-Meier estim ator, Of 228 consecutive patients, 136 (59.6%) were found suitable for init ial surgical treatment, Of the remaining 92 patients, 18 (7.8%) had nonrese ctable lymph node metastases, 16 (7.0%) had unresectable primary tumors, 13 (5.7%) refused surgery, and 13 (5.7%) presented distant metastases during initial diagnostic evaluation. Oi those who had surgery, 46 had larynx-spar ing procedures, 54 had total laryngectomy? and 36 had total laryngo-pharyng ectomy. None of the patients who had surgery died postoperatively, Actuaria l 5-year overall survival was 27.2% for all 228 patients, 39.5% for the 136 patients with surgical treatment, and 61.1% for the 46 patients who were t reated with larynx-sparing procedures,