Survival Prognosis for Advanced Hypopharyngeal Cancer Treated with Radical Hypopharyngo-laryngectomy and a Free Jejunal Graft

DOI 7 References
  • Nishimura Toshiro
    Department of Otolaryngology-Head and Neck Surgery, Kanazawa University Graduate School of Medicine
  • Yamada Kazuhiro
    Department of Otolaryngology-Head and Neck Surgery, Kanazawa University Graduate School of Medicine
  • Miwa Takaki
    Department of Otolaryngology-Head and Neck Surgery, Kanazawa University Graduate School of Medicine
  • Furukawa Mitsuru
    Department of Otolaryngology-Head and Neck Surgery, Kanazawa University Graduate School of Medicine

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  • 当科での下咽頭喉頭全摘術後に遊離空腸にて再建した進行下咽頭癌の治療成績

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Abstract

To analyze the outcome of radical surgery with a free jejunal graft performed on previously untreated advanced hypopharyngeal cancers (Stages III and IV) patients at our institution were studied to identify factors beneficial for survival. A retrospective chart review was done. The charts from January 1, 1988, through December 31, 2000 for 35 consecutive patients with previously untreated squamous cell carcinoma of the hypopharynx were reviewed. All had been treated with circumferential total laryngopharyngectomy, combined with a free jejunal graft. Survival curves calculated with the Kaplan-Meier method were compared by means of log-rank tests for specific subsets of the patient population. Factors associated with survival were further analyzed with Cox's proportional hazards model. The overall 5-year survival rate was 32.9%, and the disease-specific 5-year survival rate was 36.2%. Early (T2) primary disease was associated with a significantly better survival rate than advanced (T3 and 4) primary disease (p=0.025).<br>Although circumferential laryngopharyngectomy for hypopharyngeal cancer with a free jejunal graft is considered one of the most radical procedures, this procedure is not always successful for advanced primary (T3 and 4) disease. Because concomitant chemo-radiation therapy has been becoming the treatment of choice for advanced head and neck cancer in current clinical practice, a comparative randomized control study is needed of the surgical procedure and the chemo-radiation therapy.

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