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Sakai A, Ebisumoto K, Iijima H, Yamauchi M, Teramura T, Yamazaki A, Watanabe T, Inagi T, Maki D, Okami K. Salvage transoral videolaryngoscopic surgery for post-irradiation recurrence of hypopharyngeal carcinoma. Laryngoscope Investig Otolaryngol 2023; 8:667-674. [PMID: 37342106 PMCID: PMC10278106 DOI: 10.1002/lio2.1068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/24/2023] [Accepted: 04/17/2023] [Indexed: 06/22/2023] Open
Abstract
Background Transoral salvage surgery has the potential to preserve a patient's quality of life. Therefore, we investigated the outcomes, safety, and risk factors for postoperative complications of salvage transoral videolaryngoscopic surgery (TOVS) for recurrent hypopharyngeal carcinoma after radiotherapy (RT) or chemoradiotherapy (CRT). Methods This retrospective analysis enrolled patients with hypopharyngeal cancer who had a history of RT or CRT and underwent TOVS from January 2008 to June 2021. The factors related to postoperative complications, postoperative swallowing functions and survival rates were analyzed. Results Seven patients (36.8%) of the 19 patients developed complications. Severe dysphagia was the primary complication, and post-cricoid resection was a complication risk factor. The FOSS score was significantly lower in the salvage treatment group. The survival rates were: 3-year overall survival: 94.4%; disease-specific survival: 94.4%; 5-year overall survival: 62.3%; and disease-specific survival: 86.6%. Conclusions Salvage TOVS for hypopharyngeal cancer was feasible, and oncologically and functionally reasonable. Level of Evidence: 2b.
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Affiliation(s)
- Akihiro Sakai
- Department of Otolaryngology, Head and Neck SurgeryTokai University, School of MedicineIseharaJapan
| | - Koji Ebisumoto
- Department of Otolaryngology, Head and Neck SurgeryTokai University, School of MedicineIseharaJapan
| | - Hiroaki Iijima
- Department of Otolaryngology, Head and Neck SurgeryTokai University, School of MedicineIseharaJapan
| | - Mayu Yamauchi
- Department of Otolaryngology, Head and Neck SurgeryTokai University, School of MedicineIseharaJapan
| | - Takanobu Teramura
- Department of Otolaryngology, Head and Neck SurgeryTokai University, School of MedicineIseharaJapan
| | - Aritomo Yamazaki
- Department of Otolaryngology, Head and Neck SurgeryTokai University, School of MedicineIseharaJapan
| | - Takane Watanabe
- Department of Otolaryngology, Head and Neck SurgeryTokai University, School of MedicineIseharaJapan
| | - Toshihide Inagi
- Department of Otolaryngology, Head and Neck SurgeryTokai University, School of MedicineIseharaJapan
| | - Daisuke Maki
- Department of Otolaryngology, Head and Neck SurgeryTokai University, School of MedicineIseharaJapan
| | - Kenji Okami
- Department of Otolaryngology, Head and Neck SurgeryTokai University, School of MedicineIseharaJapan
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Cai B, Meng L, Mo J, Xu S, Qu B, Liu F, Ma L. Induction Chemotherapy Plus Simultaneous Modulated Accelerated Radiation Therapy in Non-operative Hypopharyngeal and Supraglottic Laryngeal Squamous Cell Carcinoma: Long-Term Outcome of a Prospective Phase 2 Study. Front Oncol 2021; 11:637978. [PMID: 33777795 PMCID: PMC7996365 DOI: 10.3389/fonc.2021.637978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 02/08/2021] [Indexed: 11/13/2022] Open
Abstract
Background: To evaluate the toxicities and long-term outcomes of induction chemotherapy (ICT) plus simultaneous modulated accelerated radiation therapy (SMART) in non-operative hypopharyngeal and supraglottic laryngeal squamous cell carcinoma (SCCH/L). Materials and Methods: This was a prospective phase 2 study. Patients diagnosed with SCCH/L, aged from 18 to 75, staged from III to IVB in accordance with the AJCC 2010 criteria, and refusing surgery were eligible. The patients were treated with 2-3 cycles of docetaxel-cisplatin-based ICT and SMART combined with 2-3 cycles of cisplatin-based concurrent chemotherapy. The prescription dose to the primary tumor and metastatic nodes was 69 Gy in 30 fractions. Acute and late toxicities were assessed according to the established Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer (RTOG/EORTC) criteria, and long-term outcomes were analyzed. Results: Between February 2013 and June 2015, 55 newly diagnosed SCCH/L patients were enrolled. No grade 2 or worse acute xerostomia was noted. The incidences of grade 3 acute dermatitis, oral mucositis, and pharyngoesophagitis were 12.7, 3.6, and 12.7%, respectively. The median follow-up time was 48 months (range 5.5-74 months). The main late toxicity was hoarseness or sore throat, with an incidence of 32.7%. The 5-year functional larynx-preservation survival was 51.5%. The 3- and 5-year locoregional control and overall survival were 58.2, 51.5, 63.6, and 54.1%, respectively. Conclusions: The ICT plus SMART with a regimen of 69 Gy/30 F for the treatment of SCCH/L demonstrated acceptable severe toxicity, satisfactory long-term outcomes, and laryngeal function preservation.
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Affiliation(s)
- Boning Cai
- Department of Radiation Oncology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Lingling Meng
- Department of Radiation Oncology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Jingzi Mo
- Department of Hematology and Oncology, The 921st Hospital of Chinese PLA, The Second Affiliated Hospital of Hunan Normal University, Changsha, China
| | - Shouping Xu
- Department of Radiation Oncology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Baolin Qu
- Department of Radiation Oncology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Fang Liu
- Department of Radiation Oncology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Lin Ma
- Department of Radiation Oncology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
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Tomifuji M, Araki K, Yamashita T, Shiotani A. Salvage Transoral Videolaryngoscopic Surgery for radiorecurrent hypopharyngeal and supraglottic cancer. Auris Nasus Larynx 2016; 44:464-471. [PMID: 27856033 DOI: 10.1016/j.anl.2016.10.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 09/16/2016] [Accepted: 10/19/2016] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To evaluate the feasibility of Transoral Videolaryngoscopic Surgery (TOVS) for radiorecurrent supraglottic and hypopharyngeal cancer, and to compare survival and complications between primary and radiorecurrent cases. METHODS Twelve cases of salvage TOVS for radiorecurrent cancer and 53 cases of TOVS as an initial treatment (primary cases) were evaluated. Days to resume soft diet, Functional Outcomes of Swallowing Scale (FOSS), postoperative complications, epithelization days and survival outcomes were assessed by retrospective chart review. RESULTS FOSS score was significantly worse in salvage cases compared with primary cases. Bleeding and airway compromise was slightly greater in salvage cases than in primary cases; however, this was not statistically significant. Wound healing was significantly delayed in salvage cases compared with primary cases (P<0.001). In primary cases, wounds were re-epithelized within 60 days in 83% of patients and within 90 days in almost all patients, while in salvage cases 42% of patients required more than 90 days for wound healing. In salvage cases, the 5-year overall survival, disease specific survival rate, local control rate, and laryngeal preservation rate was 85.7%, 85.7%, 62.5%, and 78.0%, respectively, and 85.7%, 98.0%, 91.3%, and 97.8%, respectively, for primary cases. Local control rate was significantly better in primary cases than in salvage cases. CONCLUSION Salvage TOVS was feasible in highly selected cases. After serial transoral surgery, the final laryngeal preservation rate was satisfactory. Swallowing function in salvage cases tended to be worse than in primary cases, and a significantly longer time was required for wound healing.
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Affiliation(s)
- Masayuki Tomifuji
- National Defense Medical College, Department of Otolaryngology - Head and Neck Surgery, Saitama, Japan.
| | - Koji Araki
- National Defense Medical College, Department of Otolaryngology - Head and Neck Surgery, Saitama, Japan
| | - Taku Yamashita
- Kitasato University School of Medicine, Department of Otorhinolaryngology - Head and Neck Surgery, Kanagawa, Japan
| | - Akihiro Shiotani
- National Defense Medical College, Department of Otolaryngology - Head and Neck Surgery, Saitama, Japan
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Homma A, Hatakeyama H, Mizumachi T, Kano S, Sakashita T, Kuramoto R, Nakamaru Y, Onimaru R, Tsuchiya K, Yoshida D, Yasuda K, Shirato H, Fukuda S. A Retrospective Study of G-Tube Use in Japanese Patients Treated with Concurrent Chemoradiotherapy for Hypopharyngeal Cancer. PLoS One 2016; 11:e0161734. [PMID: 27556279 PMCID: PMC4996531 DOI: 10.1371/journal.pone.0161734] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 08/10/2016] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Late toxicity after concurrent chemoradiotherapy (CCRT), such as dysphagia, in patients with squamous cell carcinoma of the head and neck has received a good deal of attention recently. The gastrostomy tube (G-tube) dependence rate 1 year after CCRT was reported to be 16.7-42.9% in Western countries. We evaluated swallowing outcomes after CCRT in patients with hypopharyngeal cancer (HPC) treated in our hospital and compared them with previous reports. METHODS We reviewed 96 consecutive patients with a HPC treated by radiotherapy with intravenous or intra-arterial chemotherapy between 2006 and 2013 at Hokkaido University Hospital, Sapporo, Japan. RESULTS At 1 month after CCRT, 13 patients (13.7%) used a G-tube, whereas 5/91 (5.5%) and 4/81 (4.9%) used a G-tube at 3 and 6 months, respectively. Two patients used a G-tube at 12 and 24 months after CCRT (G-tube use rate: 2.8% at 12 months, and 3.2% at 24 months). The variables female, posterior wall primary, stage IV, ECOG performance status of 2, and smoking status were significantly associated with G-tube use at 12 months after CCRT, whereas the route of cisplatin administration was not related to G-tube use (p = 0.303). CONCLUSIONS The G-tube use rate up to 1year could be lower in Japanese patients than in Western patients according to previous reports. In particular, Japanese patients resume oral intake sooner than Western patients. Further study of the incidence of dysphagia after CCRT by ethnicity is required to clarify the differences in dysphagia after CCRT.
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Affiliation(s)
- Akihiro Homma
- Department of Otolaryngology-Head & Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
- * E-mail:
| | - Hiromitsu Hatakeyama
- Department of Otolaryngology-Head & Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Takatsugu Mizumachi
- Department of Otolaryngology-Head & Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Satoshi Kano
- Department of Otolaryngology-Head & Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Tomohiro Sakashita
- Department of Otolaryngology-Head & Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Rinnosuke Kuramoto
- Department of Otolaryngology-Head & Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yuji Nakamaru
- Department of Otolaryngology-Head & Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Rikiya Onimaru
- Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Kazuhiko Tsuchiya
- Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Daisuke Yoshida
- Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Koichi Yasuda
- Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Hiroki Shirato
- Department of Radiation Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Satoshi Fukuda
- Department of Otolaryngology-Head & Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Hall SF, Griffiths R. Did the addition of concomitant chemotherapy to radiotherapy improve outcomes in hypopharyngeal cancer? A population-based study. ACTA ACUST UNITED AC 2016; 23:266-72. [PMID: 27536177 DOI: 10.3747/co.23.3085] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND For oncologists and for patients, no site-specific clinical trial evidence has emerged for the use of concurrent chemotherapy with radiotherapy (ccrt) over radiotherapy (rt) alone for cancer of the hypopharynx (hpc) or for other human papilloma virus-negative head-and-neck cancers. METHODS This retrospective population-based cohort study using administrative data compared treatments over time (1990-2000 vs. 2000-2010), treatment outcomes, and outcomes over time in 1333 cases of hpc diagnosed in Ontario between January 1990 and December 2010. RESULTS The incidence of hpc is declining; the use of ccrt that began in 2001 is increasing; and the 3-year overall survival for all patients remains poor at 34.6%. No difference in overall survival was observed in a comparison of patients treated in the decade before ccrt and of patients treated in the decade during the uptake of ccrt. CONCLUSIONS The addition of ccrt to the armamentarium of treatment options for oncologists treating head-and-neck patients did not improve outcomes for hpc at the population level.
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Affiliation(s)
- S F Hall
- Department of Otolaryngology/Head and Neck Surgery, Kingston, ON
| | - R Griffiths
- ices Queen's, Queen's University, Kingston, ON
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Li P, Li S, Yang X, Tang Q, He X, Wang S. Application of xenogenic acellular dermal matrix in reconstruction of oncological hypopharyngeal defects. Eur Arch Otorhinolaryngol 2016; 273:4391-4396. [DOI: 10.1007/s00405-016-4088-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 05/05/2016] [Indexed: 10/21/2022]
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Poort LJ, Bloebaum MMF, Böckmann RA, Houben R, Granzier MEPG, Hoebers FJ, Kessler PAWH. Assessment of local blood flow with laser Doppler flowmetry in irradiated mandibular and frontal bone, an experiment in Göttingen minipigs. J Craniomaxillofac Surg 2016; 43:2071-7. [PMID: 26776291 DOI: 10.1016/j.jcms.2015.10.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Revised: 09/29/2015] [Accepted: 10/12/2015] [Indexed: 11/26/2022] Open
Abstract
PURPOSE The aim of this study was to investigate local blood flow changes in the mandibular bone compared to the os frontale after irradiation in various doses. MATERIALS AND METHODS This study used an animal experiment with 16 female Göttingen minipigs. Three groups of four animals were irradiated with equivalent doses of 25, 50 or 70 Gray on the mandible and os frontale and four animals served as control. Three months after irradiation laser Doppler flowmetry (LDF) was used to record local blood flow on the left mandible and in the irradiated area on the os frontale. At 6 months measurements were repeated. Descriptive and univariate analyses were conducted and p-values lower than 0.05 were considered statistically significant. RESULTS Local blood flow measurements in the mandible were significantly higher compared to the os frontale. In the os frontale and mandible there was no significant change in the measurements with increasing irradiation dose. CONCLUSION We found a non-significant decrease in LDF values with an increase in radiation dose in the mandible and non-significant changes in the os frontale at 3 and 6 months. We consider this to represent the process of on-going fibrosis affecting the local blood flow in the mandible.
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Hurst NJ, Dominello M, Dyson G, Jaratli H, Sharma M, Ahmed YK, Melkane AE, Rose C, Jacobs J, Giorgadze T, Kim H. Intratumoral lymphatic vessel density as a predictor of progression-free and overall survival in locally advanced laryngeal/hypopharyngeal cancer. Head Neck 2015; 38 Suppl 1:E417-20. [PMID: 25641342 DOI: 10.1002/hed.24011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2015] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Lymphatic vessel density (LVD) has been shown to be an important predictor of survival in head and neck cancers. We report the predictive value of LVD for progression-free survival (PFS) and overall survival (OS) in laryngeal/hypopharyngeal cancer. METHODS Fifty-five untreated patients with T3/T4 laryngeal and T4 hypopharyngeal cancer underwent laryngectomy between 1999 and 2010. Surgical specimens were immunostained with D2-40, a specific lymphatic marker. LVDs were determined in tumor vessel "hot spots." Recursive partitioning analysis identified LVD thresholds for both peritumoral (LVDpt) and intratumoral (LVDit) vessels for association with PFS and OS. RESULTS Patients with mean LVDit of <11 vessels/mm(2) had 2-year PFS and OS rates of 58% and 65%, respectively, compared to 13% and 13% for those with LVDit ≥11 vessels/mm(2) (p = .06 and .04, respectively). CONCLUSION Intratumoral lymphatic vessel density is predictive of PFS and OS in locally advanced laryngeal/hypopharyngeal cancer. © 2015 Wiley Periodicals, Inc. Head Neck 38: E417-E420, 2016.
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Affiliation(s)
- Newton J Hurst
- Department of Radiation Oncology, Wayne State University, Detroit Medical Center, Karmanos Cancer Center, Detroit, Michigan
| | - Michael Dominello
- Department of Radiation Oncology, Wayne State University, Detroit Medical Center, Karmanos Cancer Center, Detroit, Michigan
| | - Gregory Dyson
- Department of Oncology, Wayne State University, Detroit Medical Center, Karmanos Cancer Center, Detroit, Michigan
| | - Hayan Jaratli
- Department of Pathology, Wayne State University, Detroit Medical Center, Karmanos Cancer Center, Detroit, Michigan
| | - Meenu Sharma
- Department of Pathology, Wayne State University, Detroit Medical Center, Karmanos Cancer Center, Detroit, Michigan
| | - Yasin K Ahmed
- Department of Pathology, Wayne State University, Detroit Medical Center, Karmanos Cancer Center, Detroit, Michigan
| | - Antoine E Melkane
- Department of Otolaryngology, Wayne State University, Detroit Medical Center, Karmanos Cancer Center, Detroit, Michigan
| | - Christopher Rose
- Department of Otolaryngology, Wayne State University, Detroit Medical Center, Karmanos Cancer Center, Detroit, Michigan
| | - John Jacobs
- Department of Otolaryngology, Wayne State University, Detroit Medical Center, Karmanos Cancer Center, Detroit, Michigan
| | - Tamar Giorgadze
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York
| | - Harold Kim
- Department of Radiation Oncology, Wayne State University, Detroit Medical Center, Karmanos Cancer Center, Detroit, Michigan
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Watanabe S, Ogino I, Inayama Y, Sugiura M, Sakuma Y, Kokawa A, Kunisaki C, Inoue T. Impact of the early detection of esophageal neoplasms in hypopharyngeal cancer patients treated with concurrent chemoradiotherapy. Asia Pac J Clin Oncol 2014; 13:e3-e10. [DOI: 10.1111/ajco.12274] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2014] [Indexed: 01/10/2023]
Affiliation(s)
- Shigenobu Watanabe
- Department of Radiation Oncology; Yokohama City University Medical Center; Yokohama Japan
| | - Ichiro Ogino
- Department of Radiation Oncology; Yokohama City University Medical Center; Yokohama Japan
| | - Yoshiaki Inayama
- Department of Pathology; Yokohama City University Medical Center; Yokohama Japan
| | - Madoka Sugiura
- Department of Radiation Oncology; Yokohama City University Medical Center; Yokohama Japan
| | - Yasunori Sakuma
- Department of Otorhinolaryngology; Yokohama City University Medical Center; Yokohama Japan
| | - Atsushi Kokawa
- Gastroenterological Center; Yokohama City University Medical Center; Yokohama Japan
| | - Chikara Kunisaki
- Gastroenterological Center; Yokohama City University Medical Center; Yokohama Japan
| | - Tomio Inoue
- Department of Radiology; Yokohama City University School of Medicine; Yokohama Japan
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Murono S, Tsuji A, Endo K, Kondo S, Wakisaka N, Yoshizaki T. Factors associated with gastrostomy tube dependence after concurrent chemoradiotherapy for hypopharyngeal cancer. Support Care Cancer 2014; 23:457-62. [DOI: 10.1007/s00520-014-2388-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 08/05/2014] [Indexed: 11/30/2022]
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Outcomes of anterolateral thigh flap reconstruction for salvage laryngopharyngectomy for hypopharyngeal cancer after concurrent chemoradiotherapy. PLoS One 2013; 8:e53985. [PMID: 23320112 PMCID: PMC3540016 DOI: 10.1371/journal.pone.0053985] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Accepted: 12/05/2012] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To evaluate the functional and oncological outcomes of anterolateral thigh flap reconstruction for salvage laryngopharyngectomy after concurrent chemoradiotherapy for patients with hypopharyngeal carcinoma. MATERIALS/METHODS A retrospective review was conducted on patients who underwent pharyngoesophageal reconstruction using anterolateral thigh flap after salvage laryngopharyngectomy for recurrent hypopharyngeal carcinoma between June 2003 and May 2010 at Chang Gung Memorial Hospital. The perioperative morbidity, mortality, functional outcomes, and oncological outcomes were evaluated. RESULTS 33 patients were entered into the study. The mean follow-up time was 19.5±12.3 months. Recurrent pathological TNM stages included 3 (9.1%), 2 (6.1%), and 28 (84.8%) patients with stage II, III, and IV disease, respectively. Mean ICU stay was 10.3 days and the mean hospital stay was 39.9 days. Peri-operative mortality occurred in one patient (3%). 16 patients (48.5%) developed recipient site complications. Among them, 14 patients (42.4%) developed fistulas and 9 patients (27.3%) developed strictures. Except for 4 patients (12.1%), all achieved varying degree of oral intake with 29 patients (60.6%) being completely independent from tube feeding. The mean interval to start oral intake was 15.1 days. The 5-year overall survival and disease-free survival rates were 51.8% and 53.7%, respectively. The pN status is an independent predictor of overall survival and disease-free survival (P = 0.027 and 0.038, respectively). CONCLUSION Pharyngoesophageal reconstruction after salvage laryngopharyngectomy remains challenging even in the experienced hands. Reconstructive microsurgeons who are prepared to take on these cases should be equally well prepared to manage the potential postoperative complications.
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Nomura K, Takahara M, Katayama A, Kishibe K, Kunibe I, Katada A, Hayashi T, Harabuchi Y. Intra-arterial cisplatin with concomitant radiation for advanced hypopharyngeal cancer. Laryngoscope 2012; 123:916-22. [DOI: 10.1002/lary.23870] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Revised: 09/10/2012] [Accepted: 10/11/2012] [Indexed: 02/04/2023]
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