Cancer of the hypopharynx

Squamous cell carcinoma of the hypopharynx is relatively uncommon, accounting for about 4% of all head and neck tumors, with approximately 3400 new cases diagnosed annually. However, these tumors are associated with the lowest survival rates when compared to squamous cell carcinomas in other subsites of the head and neck. This in part is due to the fact that tumors in this location tend to cause symptoms late in the course of the disease and, thus, tend to present in advanced stages. Another characteristic is their predilection for local aggressiveness, submucosal spread, and high metastatic potential. In the past, surgery was the mainstay in management, which often led to removal of the larynx. Today, organ preservation protocols, using combinations of radiation with chemotherapy and other biological agents, have become the standard for the treatment of most patients with advanced hypopharyngeal carcinoma. In this chapter, a common clinical situation, a patient with SCC of the pyriform sinus clinically staged T3N1, is used to present the reader the best available evidence on which to base decisions regarding assessment of the disease extent, surgical vs. organ preserving treatment, recommended organ preservation protocols, how to manage the neck, and what is the role for adjuvant treatment, as well as the role of the various options for reconstruction.

Duke Scholars

Author Trinitia Y Cannon Head & Neck Surgical Oncology