Abstract
A retrospective study was performed on 60 patients with fresh hypopharyngeal carcinoma. Thirteen patients with Ti and T2 without lymph node metastasis (T1, T2N0) were treated by chemoradiotherapy (CRT) alone. Fourteen patients with T1 and T2 with lymph node metastasis (T1, T2N+) were treated by preoperative CRT followed by neck dissection. Thirty-three patients with T3 or T4 were treated by total laryngopharyngectomy with cervical esophagectomy and neck dissection followed by postoperative CRT. The laryngeal preservation rates for patients with T1, T2N0 and T1, T2N+ were almost at the same levels (69% and 89%, respectively), but the rates of 5-year survival and distant metastasis for the patients with T1, T2N0 and T1, T2N+ were 83% and 38%, and 8% and 43%, respectively. The rates of 5-year survival for patients with T3, T4N0 and T3, T4N+ were almost at the same levels (72% and 55%, respectively), and the rates of distant metastasis were at a the similar level (14% and 15%, respectively) to the group with T1, T2N0. These results suggest that patients with T1, T2N+ should be treated initially by neck dissection followed by CRT in order to improve the 5-year survival rate while avoiding distant metastasis and preserving the larynx.
