A COMPARISON OF SURGERY AND RADIOTHERAPY IN THE MANAGEMENT OF POST-CRICOID CARCINOMA

One hundred and forty-three patients with post-cricoid squamous cell c arcinoma are described. Twenty-nine patients (20%) underwent pharyngol aryngoesophagectomy with gastric transposition. Forty-four patients (3 1%) were treated with radical radiotherapy and 70 (49%) had palliative therapy. Kaplan Meier 5-year survival following surgery was 45% and r adiotherapy was 23%. The presence of nodal disease at presentation was the most significant prognostic factor. The 5-year survival of patien ts undergoing surgery with no palpable lymph node spread at presentati on was 63% which compared with 25% following radiotherapy. This differ ence was statistically significant (P=0.0153: Logrank test stratified by nodal status). Patients with palpable metastatic nodal spread at pr esentation had 5-year survivals of 10% and 0% in the surgical and radi otherapy groups respectively. This study demonstrates that patients wi th post-cricoid carcinoma who present without palpable lymph node spre ad have a significant improved 5-year survival following surgery when compared with radiotherapy.