Introduction: The importance of transoral resection for hypopharyngeal carcinoma is increasing, but indications have not yet been established. This study was intended to help establish standard indications for transoral resection and additional therapy in patients with early hypopharyngeal carcinoma.
Methods: A total of 52 lesions of Tis, T1 and T2 (any N, M0) hypopharyngeal carcinoma underwent surgery at the Cancer Institute Hospital between 2005 and 2011. We measured tumor thickness and checked lymph node metastasis (LNM), lymphatic invasion, venous invasion, and noted whether death was a result of the original cancer. We additionally examined correlations between each of these items.
Results: A tumor thickness ≥2mm was associated with higher incidences of LNM. A tumor thickness ≥5mm was associated with higher incidences of death due to the original cancer. Disease-specific survival was significantly lower for tumors ≥5mm thick than for tumors <5mm thick.
Conclusions: In early hypopharyngeal carcinoma, careful observation is necessary for tumors ≥2mm thick because of the higher risk of nodal metastasis. Patients with a tumor ≥5mm thick should consider elective neck dissection, because of the higher risk of death due to the original cancer. If there is a risk of penetrating pharyngeal and cervical wounds, partial pharyngectomy using an open method must be considered instead of transoral resection.
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