Choose an application

• Reference Manager
• EndNote
• RefWorks (Direct export to RefWorks)

Introduction and aim: Hypopharyngeal squamous cell carcinoma (SCC) are generally diagnosed in advanced stage disease. We present our results of primary and salvage treatment by total laryngopharyngoesophagectomy with gastric pull up reconstruction in terms of success rate, postoperative complications, and functional and oncological outcomes. Material and methods: Retrospective analysis of 61 patients with hypopharyngeal SCC, who underwent laryngopharyngoesophagectomy with gastric pull up reconstruction between 1980 and 2015, was performed. Patient demographics and disease characteristics were described, actuarial survival rates were calculated and variables modifying complication rate and oncological outcome were analysed using chi-square, Fisher’s exact and log-rank tests. Results: 36 patients (59%) underwent laryngopharyngoesophagectomy as an up-front procedure and 25 patients (41%) were treated in salvage setting for persisting or recurrent cancer after prior therapy or for second primary cancer after previous neck irradiation. The in-hospital mortality rate was 10%. Early and late complication rates were 45% and 15% respectively, and were not statistically influenced by a history of radiotherapy (Fisher’s exact test, p=1 and p=0.64). Mean and median follow-up were 26 and 12 months (range 0.75-227 months, SD=42 months). One-year and two-year actuarial overall survival rates were 56.0% and 36.7% respectively. One-year and two-year actuarial disease specific survival rates were 74.1% and 57.2% respectively and were significantly negatively influenced by presence of nodal disease (log rank analysis, p<0.01). One-year and two-year actuarial disease recurrence rates were 49.1% and 63.3%. A significant higher disease recurrence rate was observed in patients with nodal disease (26.5% versus 65.6% at 1 year, log rank analysis, p<0.01). Complete oral intake was achieved in 80% of patients with a trend towards poorer results in patients with prior head-neck irradiation (Fisher’s exact test, p=0.016). Speech rehabilitation by means of Provox® puncture or electrolarynx was achieved in 58% of patients. Conclusions: Total laryngopharyngoesophagectomy with gastric pull up reconstruction for advanced stage hypopharyngeal SCC combines acceptable oncologic and functional outcomes in a prognostic unfavourable patient group.