沖繩県における下咽頭悪性腫瘍の臨床的観察

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Statistical observation of 226 cases of head and neck tumors, during the period of April, 1973, when Department of Ear, Nose and Throat was commenced, March, 1978, was done at the Department of Otolaryngology, University Hospital of the Ryûkyûs, College of Health Science, Okinawa.The head and neck tumors were found in approximately 4.0% of all the ENT patients in each year. The number of the patients and the locations of the malignant tumors were as follows: 38 cases (16.8%) in the oral cavity, 76 cases (33.6%) in the pharynx, 53 cases (23.5 %) in the larynx, 42 cases (18.6%) in the nasal and paranasal cavities, 2 cases (0.9%) in the acoustic organs and 15 cases (6.6%) in the other head and neck regions.The statistical details of malignant laryngopharyngeal tumors were as follows:1) Epipharyngeal tumors were found in 18 cases (23.7%), oropharyngeal tumors in 38 cases (50.0%) and laryngopharyngeal tumors in 20 cases (26.3%) out of total 76 cases. Laryngopharyngeal tumors (20 cases) occupied 8.8% of the malignant head and neck tumors.2) The ratio between males (19 cases) and females (1 case) was 19: 1.3) The age was distributed from 41 to 87 years. A peak of the incidence was in the fifth to seventh decades. The average age was 64.3 years.4) Chief complaints of the malignant laryngopharyngeal tumors were dysphagia, hoarseness, dyspnoea, cervical lymphadenopathy, pharyngeal pain, foreign body sensation and so on.5) The primary tumor sites were the postcricoid area of the laryngopharynx (2 cases-10%), posterior pharyngeal wall (3 cases-15%) and pyriform sinus (15 cases-75%). The primary tumor sites of 19 cases (males) were the pyriform sinus in 15 cases, postcricoid area in 1 case and posterior pharyngeal wall in 3 cases. That of only one female case was postcricoid area.6) Histopathology of all 20 cases showed well differentiated squamous cell carcinoma.7) According to TNM classification (UICC) and stage classification (The American Joint Committee), 4 cases (20.0%) were in stage I, 6 cases (30.0%) in stage II, 3 cases (15.0%) in stage III and 7 cases (35.0%) in stage IV. The advanced stages of III and IV were seen in 10 cases (50.0%).8) Eleven patients were treated by external radiation (mainly cobalt 60 irradiation), chemotherapy and immuno-chemotherapy. Five patients were treated by chemotherapy and immuno-chemotherapy. Pharyngolaryngoesophagectomy was performed in one case with recurrence of tumor after radiotherapy, chemotherapy, and immuno-chemotherapy, but he was died.9) The 3-year-crude survival rate in 7 patients was 0%.

沖繩県における下咽頭悪性腫瘍の臨床的観察

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