Abstract
In advanced pyriform sinus squamous cell carcinoma of the hypopharynx treated with total laryngopharyngectomy, hemithyroidectomy to total thyroidectomy and paratracheal node dissection is recommended. In general, ipsilateral paratracheal neck dissection should be conducted, but there is little evidence for surgical management for the contralateral side. We undertook a retrospective review of 117 patients with pyriform sinus carcinoma who underwent total laryngopharyngectomy for initial treatment between January 2005 and December 2015. We investigated the area of the paratracheal neck dissection, histopathological paratracheal lymph node metastasis, rate of thyroid and parathyroid hormone replacement, and prognosis. The rate of ipsilateral paratracheal lymph node metastasis was 11.1% (13 out of 117) and that of the contralateral side was 4.5% (1 out of 22). Stomal recurrence was observed in one patient. The patient underwent definitive chemoradiation followed by adjuvant chemotherapy and had no recurrence for 13 years after surgery. The rates of thyroid and parathyroid hormone replacement in patients with bilateral paratracheal neck dissection were significantly higher than those in unilateral paratracheal neck dissection. In advanced pyriform sinus squamous cell carcinoma with total laryngopharyngectomy, hemithyroidectomy and ipsilateral paratracheal lymph node dissection can be considered as a treatment option for surgical management around the paratracheal area.
