Carcinoma of the Pyriform Sinus: Analysis of 102 Cases

Abstract

The treatment of 102 patients with squamous cell carcinoma of the pyriform sinus seen at the University of Virginia Medical Center from 1958 through 1977 is reviewed. Eight-seven cases form the basis for this report. Surgery alone, radiation alone and combination of the two were the treatment modalities utilized for the patients in this study. The overall 3 year, no evidence of disease determinate survival was (37%). Recent literature has suggested that preoperative radiation obscures tumor margins with a decrease in survivals as compared to postoperative irradiation. Though the number of patients in both the preoperative (27) and postoperative (7) groups are small, our data suggests similar survivals. In addition, when pathology was examined, no tumor margins were transected in the preoperative irradiation group and only 5/23 patients had margins classified as close. The incidence of postoperative complications was not significantly difference between the combination therapy and surgery only groups. It is concluded that preoperative irradiation does not compromise the resection of adequate tumor margins nor significantly increase postoperative complications.

Pattern of cervical lymph node metastasis in medial wall pyriform sinus carcinoma

“…Hypopharynx SCC has a high tendency to invade cervical lymph nodes. This nodal extension is a well‐known prognostic factor . Therefore, control of regional metastasis is an essential part of surgical treatment for hypopharyngeal SCC …”

“…Squamous cell carcinoma (SCC) of the hypopharynx is characterized by aggressive clinical behavior and high risk of early metastasis to cervical lymph nodes. The incidence of neck metastasis of hypopharyngeal SCC ranges from 65% to 80% on presentation, and from 30% to 40% for N0 necks . For this reason, treatment modalities for hypopharyngeal SCC must address the potential for spread of disease to the neck, even for early primary tumor.…”

The impact of paratracheal lymph node metastasis in squamous cell carcinoma of the hypopharynx

“…This nodal extension is a well-known prognostic factor [8, 9]. The hypopharynx has an extensive lymphatic network.…”

Organ preservation with radiotherapy for T1‐T2 carcinoma of the pyriform sinus

“…23 In some institutions, all or almost all of the patients have been treated with operations that included total laryngectomy. [26][27][28] Another option is transoral laser excision, which would often be combined with postopera- tive RT. The criteria for transoral laser excision are not well defined, and data supporting this treatment are limited.…”