Salvage Treatment Options after Failed Primary Treatment of Hypopharyngeal Cancer.
Authors: Simo R, Rovira A, Townley W
Abstract
Recurrent hypopharyngeal cancer (rHPC) is a high-risk fatal disease associated with poor prognosis and high risk of complications in patients who are suitable to undergo salvage treatment. The treatment of such patients should be managed by a dedicated multidisciplinary team, most frequently a tertiary centre. and with the agreement of the patient. Close follow-up is crucial in achieving early detection and being able to treat the recurrence with curative intention. When persistent or recurrent disease is suspected, cross-sectional computed tomography imaging (...
Source: Advances in Oto-Rhino-Laryngology - April 4, 2019 Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
Primary Treatment of T1-T2 Hypopharyngeal Cancer: Changing Paradigms.
Authors: Meulemans J, Delaere P, Vander Poorten V
Abstract
There has been a general shift in the treatment of hypopharyngeal cancer from open surgical techniques (either radical or partial "organ" preserving) toward non-surgi cal "organ preserving" strategies (radiotherapy [RT] or chemoradiotherapy [CRT]) and minimally invasive transoral laser microsurgery (TLM) or transoral robotic surgery (TORS). Oncologic outcomes reported are comparable whatever modality is chosen, but better functional outcomes are observed in the RT/CRT and TLM/TORS-treated patients. Because of the high rate of second primary maligna...
Source: Advances in Oto-Rhino-Laryngology - April 4, 2019 Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
Natural History of Treated and Untreated Hypopharyngeal Cancer.
Authors: Eckel HE, Bradley PJ
Abstract
Patients with hypopharyngeal cancers frequently present at advanced stage and in poor general health status. Their natural history is characterised by diffuse local primary disease, mucosal and submucosal spread, early cervical nodal metastasis, and a relatively high rate of distant spread. By the time of initial diagnosis, some 60% of all hypopharyngeal cancer patients will be with stage IV disease, some 5% will present with distant metastases, and almost 40% will have a significant reduction in performance status. Less than 20% are diagnosed with a localised early s...
Source: Advances in Oto-Rhino-Laryngology - April 4, 2019 Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
Surgical Treatment of Advanced Staged Hypopharyngeal Cancer.
Authors: Wei WI, Chan JYW
Abstract
It is not uncommon for patients with hypopharyngeal cancer to present at an advanced stage of disease. Surgical treatment provides a cure for the tumour with immediate relief from obstruction to the airway and the swallowing passage. Careful planning of surgery is important to ensure good outcome of treatment and prevent complications, some of which may be fatal. The shape of the hypopharynx resembles that of a funnel, with a wide circumference above in continuity with the oropharynx, and a small circumference below where it joins with the cervical oesophagus. As a result...
Source: Advances in Oto-Rhino-Laryngology - April 4, 2019 Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
Systemic Therapy, Palliation and Supportive Care of Patients with Hypopharyngeal Cancer.
Authors: Bradley PJ, Füreder T, Eckel HE
Abstract
Hypopharyngeal cancer patients have a very poor prognosis and limited therapeutic options. Seventy to eighty per cent of all hypopharyngeal cancer patients will require palliative and/or end-of-life care for incurable end-stage disease during the course of their illness. The overall proportion of hypopharyngeal cancer patients not qualifying for initial curative treatment, or requiring palliation and supportive care over time is higher than for any other subsite of the head and neck. Surgery and radiotherapy usually have a very limited role in this setting...
Source: Advances in Oto-Rhino-Laryngology - April 4, 2019 Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
Epidemiology of Hypopharyngeal Cancer.
Authors: Bradley PJ
Abstract
Hypopharyngeal cancer is uncommon in the developed world; it is mostly diagnosed in men who smoke tobacco and consume excessive alcohol and uncommon in women. However, recent trends in the developed world show that there has been an annual increase in the percentage of women with hypopharyngeal cancer. In France, there has been a significant annual percentage change in the incidence of this form of cancer - a decrease in men and a greater increase in women since the 1980s. In the developing world, India, Taiwan and other countries, the incidence of hypopharyngeal cancer has inc...
Source: Advances in Oto-Rhino-Laryngology - April 4, 2019 Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
Symptoms and Signs, Staging and Co-Morbidity of Hypopharyngeal Cancer.
Authors: Bradley PJ
Abstract
Early throat symptoms are common and a diagnosis of hypopharyngeal cancer rare; therefore, confirming or excluding a serious diagnosis is missed or overlooked by both the patient and the practitioner - however, symptoms such as throat clearing and food sticking, which persist in adult patients who have the social habit of tobacco usage and/or drink excessive alcohol should be examined by a specialist to exclude the presence of hypopharyngeal cancer. Late symptoms/signs include neck swelling (uni- or bilateral), dysphagia, odynophagia, otalgia, dysphonia, dyspnoea and stridor. A...
Source: Advances in Oto-Rhino-Laryngology - April 4, 2019 Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
Treatment Options for Hypopharyngeal Cancer.
Authors: Eckel HE, Bradley PJ
Abstract
Patients with hypopharyngeal cancer are difficult to treat because they typically present with advanced disease, poor general health status and severe nutritional problems. Currently, treatment options for previously untreated and newly diagnosed hypopharyngeal cancer patients include surgery of the primary tumour and lymph nodes metastasis, radiotherapy, systemic medical treatment, including traditional chemotherapy and immunotherapy. Currently, a multimodal treatment approach is preferred using surgery, radiotherapy and systemic therapy with curative intent and best...
Source: Advances in Oto-Rhino-Laryngology - April 4, 2019 Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
Clinical and Radiological Evaluation of Hypopharyngeal Carcinoma.
Authors: Piazza C, Paderno A, Ravanelli M, Pessina C
Abstract
Pre-treatment clinical and radiological evaluations represent a key step in the proper management of hypopharyngeal carcinoma. First, office-based endoscopy allows the assessment of superficial tumor extension, signs of laryngeal infiltration, and the overall residual function of the laryngo-hypopharyngeal complex. Different tools, maneuvers, and techniques can improve this essential diagnostic step and should be considered a prerequisite to direct subsequent investigations and give an initial indication for the most appropriate treatment. Furth...
Source: Advances in Oto-Rhino-Laryngology - April 4, 2019 Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
Outcomes of Tumour Control from Primary Treatment of Hypopharyngeal Cancer.
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 surgica...
Source: Advances in Oto-Rhino-Laryngology - April 4, 2019 Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
Treatment Options for Hypopharyngeal Cancer in Developing Countries in Africa/South America/Asia.
Authors: Fagan JJ, Chaturvedi P, Kowalski LP
Abstract
Most cancers occur in developing countries, and therefore, a discussion about cancer care would be incomplete without providing a developing world perspective. This chapter focuses on challenges and practices relating to hypopharyngeal cancer in limited-resource public healthcare systems in developing countries and specifically in Sub-Saharan Africa, India and South America and by extension, most patients in the developing world. Management of hypopharyngeal cancer must be adapted to the availability of specialised diagnostic and therapeutic services, r...
Source: Advances in Oto-Rhino-Laryngology - April 4, 2019 Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
The Current Indications for Non-Surgical Treatment of Hypopharyngeal Cancer.
Authors: de Bree R
Abstract
The management of hypopharyngeal cancer is challenging because of poor patient survival and the potential effects of treatment on breathing, voice and swallowing. In general, early stage hypopharyngeal cancer can be primarily treated by radiotherapy or conservative transoral or open surgery, whereas advanced stage hypopharyngeal cancer can be treated by non-surgical protocols if the patient has no loss of functions (dysfunctional larynx) and/or cartilage invasion (T4a). Factors to determine individualized patient treatment include resectability, tumour volume, distant metastases...
Source: Advances in Oto-Rhino-Laryngology - February 14, 2019 Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
Sequelae and Complications of Treatment for Hypopharyngeal Cancer: Minimising the Risks.
Authors: Sewnaik A, Baatenburg de Jong RJ
Abstract
Treatment of hypopharyngeal cancer depends on the extent and location of the tumour, patient-specific or by factors (age, performance status, co-morbidity) and the presence of psychosocial support. Options available for the treatment of hypopharyngeal cancer consist of surgery and non-surgery - radiotherapy, chemoradiation, bioradiation, or a combination of these modalities. To maintain normal functioning as much as possible, functional organ preservation is widely recommended and generally utilizes radiotherapy and/or chemoradiation. Although functional o...
Source: Advances in Oto-Rhino-Laryngology - February 14, 2019 Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
Swallowing and Voice Outcomes following Treatment of Hypopharyngeal Cancer: The Need for Supervised Rehabilitation.
Authors: Eerenstein SEJ, Verdonck-de Leeuw IM, Leemans CR
Abstract
Advances in and intensification of treatment in hypopharyngeal cancer have led to an increase in organ preservation and in overall survival. Treatment intensification comes at the cost of more pronounced acute and long-term side effects causing functional impairments in voice and swallowing. Swallowing and voice problems have a significant impact on communication, eating and nutrition, social well-being and quality of life. Swallowing problems may be so severe that patients suffer profuse aspiration or are left gastrostomy-tube dependent. P...
Source: Advances in Oto-Rhino-Laryngology - February 14, 2019 Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
Extended Applications for Cochlear Implantation.
Authors: Hempel JM, Simon F, Müller JM
Abstract
The indications for cochlear implantation (CI) have expanded over the last few years. There is evidence that some adult patients with pre- or perilingual onset of deafness may gain from implantation. Similarly, CI in patients with single-sided deafness may offer significant benefits in terms of quality of life and social as well as academic development. In this setting, directional hearing may be restored and speech comprehension, especially in noise, may be optimized. In patients with intractable tinnitus and profound hearing loss, CI not only improves spee...
Source: Advances in Oto-Rhino-Laryngology - May 30, 2018 Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
