Impact of the method and success of pharyngeal reconstruction on the outcome of treating laryngeal and hypopharyngeal cancers with pharyngolaryngectomy: A national analysis

Nouraei, S.A.R.; Dias, Ayesha; Kanona, Hala; Vokes, David E.; O’Flynn, Paul; Clarke, Peter; Middleton, Steve; Darzi, Ara; Aylin, Paul; Jallali, Navid

doi:10.1016/j.bjps.2016.12.009

Cited by 18 publications

(12 citation statements)

References 25 publications

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“…Choice of reconstruction, and specifically the use of alimentary tract conduits, worsens short-and long-term survival. This may be due to added physiological stress the patient is placed under because of the opening of abdominal or thoracic and abdominal cavities [39]. Functional results are, in the best-case scenario, comparable with those obtained using fasciocutaneous free flaps.…”

Section: Discussionmentioning

confidence: 82%

“…Piazza et al showed that first-line application of RF and ALT free flaps with long-lasting salivary by-pass stent in reconstruction after partial or total pharyngo-laryngectomy allows obtaining reduced incidences of both fistula and stenosis [24]. Nouraei et al [39] supported the use of free flaps even in terms of overall survival regardless of tumor stage (p < 0.05). The treatment sequence should be taken in account; our believe, confirmed by literature, is that primary definitive radiotherapy followed by salvage surgery when indicated, is inferior in terms of survival and functional outcome [41].…”

Section: Discussionmentioning

confidence: 99%

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Partial pharyngolaryngectomy with infrahyoid flap: Our experience

Cortese

Muratori

Mastronicola

et al. 2019

American Journal of Otolaryngology

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We evaluated a cohort of advanced hypopharyngeal squamous cell carcinoma, treated with conservative surgery, reconstruction with infrahyoid flap and radio-chemotherapy. Methods: We used partial pharyngo-laryngectomy and radio-chemotherapy to treat fifty-seven patients with stage III-IV hypopharyngeal SCC from November 1994 to December 2011. Clinical examination and speech therapy evaluation were used for estimation of laryngeal function. Results: All patients received a partial pharyngo-laryngectomy. All patients underwent neck dissection; 56 patients received bilateral neck dissection. Reconstruction was achieved by infra-hyoid flap. Five-year overall and disease-specific survival rates were 54.4% and 61.4%, respectively. Successful laryngeal function preservation with complete five-year remission was achieved in 44% of the patients. Conclusion: Selected even if advanced carcinomas of the hypopharynx maybe treated with partial pharyngolaryngectomy with reconstruction with pedicled flap. Both oncological and functional results showed a good outcome.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Partial pharyngolaryngectomy with infrahyoid flap: Our experience

Cortese

Muratori

Mastronicola

et al. 2019

American Journal of Otolaryngology

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“…In keeping with published trends, the majority of patients were male and aged in their 60s. 6,7 The number of patients presenting with late disease (stage III or IV, AJCC Seventh Edition criteria) was 100%, notably higher than that quoted in other published studies which range from 70% to 85%. 2,8 Prior data from the same unit at Princess Alexandra Hospital a decade earlier found only 67.8% of patients presented with stage III or IV disease.…”

Section: Discussionmentioning

confidence: 74%

Primary pharyngolaryngectomy with jejunal free flap reconstruction: a single centre's evolving experience

Henrys

Slaughter

Bernard

et al. 2020

ANZ Journal of Surgery

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Background: Head and neck squamous cell carcinoma, and in particular hypopharyngeal squamous cell carcinoma, has long been associated with disfiguring treatment options, significant morbidity and limited long-term survival outcomes. Total pharyngolaryngectomy (TPL) with free flap reconstruction followed by post-operative radiation therapy or chemoradiotherapy is a widely accepted treatment of choice for advanced disease of the hypopharynx. Methods: Our unit undertook a 11-year review of all primary TPL patients aiming to provide an update on survival outcomes, morbidity, post-operative complications and evolving management strategies. We report one of the largest single-centre series to date with 89 patients undergoing primary TPL between 2003 and 2013, and compare these outcomes to 180 patients undergoing TPL at the same facility in the previous 23 years. Results: Between study periods, we saw a shift in patient population towards higher stage disease (T-stage 3 or 4

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“…There have been multiple modifications and improvements in the procedure since it was first performed. In the present day, reconstructive options include primary closure, local flap closure, pectoralis myocutaneous flap closure, free tissue transfer (including radial forearm, free jejunum flap and anterolateral thigh flap) and gastric pull‐up . The main reconstructive goal is to create a conduit from the oropharynx to the cervical oesophagus.…”

Section: Introductionmentioning

confidence: 99%

“…In the present day, reconstructive options include primary closure, local flap closure, pectoralis myocutaneous flap closure, free tissue transfer (including radial forearm, free jejunum flap and anterolateral thigh flap) and gastric pull-up. 2 The main reconstructive goal is to create a conduit from the oropharynx to the cervical oesophagus. The ideal reconstructive method minimises perioperative morbidity, does not delay initiation of adjuvant therapies and allows optimal restoration of swallow function.…”

Section: Introductionmentioning

confidence: 99%