Outcomes of Tumour Control from Primary Treatment of Hypopharyngeal Cancer.

Outcomes of Tumour Control from Primary Treatment of Hypopharyngeal Cancer. Adv Otorhinolaryngol. 2019;83:90-108 Authors: Siddiq S, Paleri V Abstract Hypopharynx cancer continues to pose a clinically challenging head and neck subsite, driven not only by the unique set of patient, anatomic and disease factors but also by the paucity of robust clinical data to guide clinical decision making. The standard of care of radical surgery (pharyngolaryngectomy) in combination with postoperative radiotherapy was the previously accepted norm in the setting of advanced hypopharynx cancer, but this was often at the expense of significant morbidity. In the absence of survival benefit for advanced staged disease with radical surgical approaches, over the last 2 decades, the philosophy of quality of life in survivors has driven the agenda for new therapeutic approaches. The adoption of functional larynx preservation strategies has seen a paradigm shift in the treatment of this subsite since the 1990s with the advent of chemoradiation and intensity-modulated radiotherapy, thereby introducing a reducing trend for radical surgery. However, radical surgery (pharyngolaryngectomy) has a role in the non-functioning larynx (either pre- or post-treatment), in advanced volume disease and the more technically challenging salvage setting because of residual or recurrent disease. In earlier stage disease, transoral laser microsurgery and robotic surgery have show...
Source: Advances in Oto-Rhino-Laryngology - Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research