The Results of the Treatment for Carcinoma of the Hypopharynx and Cervical Esophagus

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One hundred and forty-nine patients were diagnosed as having hypopharyngeal cancer in the past sixteen years. One hundred and thirty-eight cases were followed up for this study, of whom 129 had been treated by us. The analysis of the methods and results of the treatment is presented in this paper. The results and conclusions obtained were as follows.1. According to UICC classification (1974), 138 cases were situated as follows: 89, piriform sinus; 37, pharyngo-oesophageal junction; and 12, posterior pharyngeal wall.2. The treatment methods applied to the 138 cases were: irradiation alone, 71 cases (radical irradiation, 48; and palliative irradiation, 23); surgery alone, 17 cases; irradiation plus surgery, 41 cases (relapsed cases following radical irradiation, 26; and preoperative irradiation 15); and the untreated, 9 cases.3. Surgical treatments applied to the 58 local carcinomas were composed of pharyngoesophagectomy in 26 with the reconstruction of the esophagus, pharyngolaryngectomy in 27, partial resection of the larynx and pharynx in 3, partial resection of the pharynx in 1 and partial resection of the esophagus in 1.4. The essential method of the reconstruction of the esophagus following pharyngolaryngoesophagectomy was the use of a deltopectoral flap in the past nine years.5. The most frequent surgical method applied to the piriform sinus cancers was pharyngolaryngectomy, whereas in most of the cancers located in the pharyngo-oesophageal junction pharyngolaryngoesophagectomy was the essential method.6. Radical neck dissection was applied to 55 of the 58 patients treated surgically, of whom 37 were unilateral and 18 were bilateral.7. The five-year survival rate for all the patients was 25.6%. The necessity of a well-coordinated treatment system including irradiation, surgery and chemotherapy for the elevation of the survival rate was emphasized.8. The most frequent cause of death in the patients treated surgically was local recurrence and more than ninty percent of the cause of death were associated with the original disease such as local recurrence, recurrence of the cervical lymph node and distant metastasis.

The Results of the Treatment for Carcinoma of the Hypopharynx and Cervical Esophagus

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