Hypopharyngeal carcinoma: Do you know your guidelines?

Abstract

Background Hypopharyngeal carcinoma is relatively rare, representing approximately 3% of all head and neck malignancies. It also is characterized by having one of the worst prognoses at time of diagnosis. This is largely due to its tendency for late presentation. Methods This article will review current literature including as well as the National Comprehensive NCCN Guidelines Cancer Network Clinical Practice Guidelines in Oncology (NCCN Guidelines) for the treatment of hypopharyngeal cancer. Results Hypopharyngeal cancer often presents in an advanced stage and its prognosis is notoriously poor. Treatment goals are similar to other carcinomas of the head and neck and treatment typically involves multiple modalities including surgery, radiation, and chemotherapy. Organ sparing nonsurgical therapy has shown comparable survival outcomes to surgery in early stage hypopharyngeal cancer. Conclusion Treating hypopharyngeal cancer remains a challenging prospect for the head and neck oncologist. A multidisciplinary approach is essential due to the necessity of combined therapy treatment protocols. There is opportunity for novel treatments and prospective trials to improve outcomes in hypopharyngeal carcinoma. Disease prevention by targeting environmental risk factors is likely to have the greatest impact in this disease.

Intravoxel Incoherent Motion Magnetic Resonance Imaging for Prediction of Induction Chemotherapy Response in Locally Advanced Hypopharyngeal Carcinoma: Comparison With Model‐Free Dynamic Contrast‐Enhanced Magnetic Resonance Imaging

“…Approximately 80% of hypopharyngeal tumors arise from the pyriform sinus 2 . Most cases are diagnosed at a locally advanced stage due to the specific anatomical position of tumors and varied clinical manifestations of patients 3 . The locally advanced hypopharyngeal carcinoma (LAHC) is unresectable and tends to develop regional and distant metastasis 4 …”

Recurrence of laryngeal squamous cell carcinoma in patients undergoing organ preservation therapy: are there symptoms associated with recurrence?

“…Despite recent advances in chemotherapy, radiotherapy and reconstruction surgery, there is still no preferential treatment for laryngopharyngeal neoplasms 5 . There is currently, however, a global trend toward therapeutic strategies aiming at organ preservation.…”

Prognostic factors after transoral resection of early hypopharyngeal cancer

“…Since the hypopharynx and adjacent organs, as well as the larynx, can directly influence vocal and swallowing functions, minimally invasive treatment is required for early‐stage cancers arising from their lesions. NCCN guideline recommends definitive radiotherapy (RT) or partial laryngopharyngectomy with neck dissection for hypopharyngeal carcinoma 2 . However, RT may cause laryngopharyngeal dysfunction 3 and carotid artery stenosis/thrombus 4 as late adverse events.…”

“…NCCN guideline recommends definitive radiotherapy (RT) or partial laryngopharyngectomy with neck dissection for hypopharyngeal carcinoma. 2 However, RT may cause laryngopharyngeal dysfunction 3 and carotid artery stenosis/thrombus 4 as late adverse events. In addition, second occurrences of primary head and neck and/or esophageal cancers are common in patients with hypopharyngeal cancer, especially in chronic drinkers with heterozygous ALDH2, which is common in Japan and East Asian countries.…”