Unresectable cases of hypopharyngeal cancer

Abstract

The criteria for unresectable head and neck tumors have been unclear so far and are varied between institutions. While 299 patients with hypopharyngeal cancer were enregistered in our institution between 1993 and 2002, unresectable tumors were detected in 16 cases prior to treatment. These cases were investigated retrospectively to know the findings which technical unresectability of tumors based upon. Every lesion was evaluated with X-ray CT or MRI. The most impactive factor on unresectability in cases of hypopharyngeal cancer was carotid artery involvement by cervical metastasis. X-ray CT images or MR images of 9 cases available for this study were reviewed for the degree of involvement by tumors. The images showed 180° to 360° circumferential involvement of the carotid artery in unresectable tumors. Unresectability in the cases of 180° to 240° circumferential involvement depended upon involvement of the carotid bifurcation, skull base involvement or longitudinally wide carotid involvement which were confirmed simultaneously with diagnostic imaging. We believe standing on the report that 270° or less of circumferential involvement can be resectable but the findings described as above should be put in to the criteria. It is necessary to standardize the criteria for unresectability based on imaging studies in order to choose appropriate modalities for cases of head and neck cancers.