Oncological and Functional Evaluation of Open Conservation Surgery for Hypopharyngeal Cancer with/without Reconstruction

Abstract

Objectives Oncological and functional results of open conservation surgery for hypopharyngeal cancer have been desired. Methods We performed a chart review of 33 patients with hypopharyngeal cancer who underwent open conservation surgery. Oncological and functional results were evaluated in surgery with primary closure (Group A) and surgery with reconstruction (Group B). Postoperative functions were evaluated by interval to resumption of oral intake, Functional Outcome Swallowing Scale (FOSS) and Communication Scale (CS). Results Five-year disease-specific and overall cumulative survival rates by Kaplan-Meier method for all cases were 95.7% and 82.3%, respectively. Duration from surgery to full oral intake was 12 days in Group A and 14 days in Group B. FOSS rates were 83.3 in Group A and 95.5 in Group B. CS was 0 in both groups. Conclusion Oncological and functional results of open conservation surgery were comparable to those with transoral surgery and chemo/radiotherapy. Our technique represents a reliable treatment for hypopharyngeal cancer.

Survival and swallowing function outcome impact factors analysis of surgery-oriented comprehensive treatment for hypopharyngeal cancer in a series of 122 patients

“…A functioning contra-lateral “crico-arytenoid unit” was paramount when considering LPS, 1,18 while the N status of the patients’ disease generally did not influence the type of LPS surgery undertaken. Furthermore, it was paramount for LPS candidates to have a good pulmonary functional reserve, motivation, and psychological support to ensure that they could cope with the potentially prolonged period possibly required for swallowing rehabilitation.…”

“…The swallowing function was evaluated regarding a functional outcome swallowing scale (FOSS). 1 Symptom criteria ranged from stage 0 (normal function and asymptomatic) to stage V (nonoral feeding for all nutrition). Swallowing function at or above stage III was considered satisfactory because patients could swallow orally, and aspiration was avoided.…”

“…Hypopharyngeal cancer (HPC) is reported as one of the most aggressive cancers of the head and neck region. [1][2][3][4] The primary tumor commonly causes intra-luminal obstruction of the upper aerodigestive tract, leading to progressive swallowing problems (dysphagia), hoarseness of voice (dysphonia), and airway compromise (dyspnea). 5 Most patients present with advancedstage disease at the initial diagnosis.…”

Efficacy of Larynx Preservation Surgery and Multimodal Adjuvant Therapy for Hypopharyngeal Cancer: A Case Series Study

“…A precondition for LPS is a functioning contralateral "cricoarytenoid unit," whereas N status does not seem to matter. 26,29 We further suggest that patients selected for surgery should have good pulmonary functional reserves, motivation, and access to psychological support to ensure that they can cope with prolonged swallowing rehabilitation. 3 The patient's systemic condition is another factor to consider when deciding for or against LPS.…”

“…Although numerous case series have examined HPC patients treated by LPS, 9,11,12,26,[30][31][32][33][34] not all reported functional outcomes (Table 3). Nevertheless, the available data suggest that most patients have satisfactory swallowing function.…”