Oncological and functional outcomes of partial or total laryngopharyngectomy for hypopharyngeal cancer with thyroid or cricoid cartilage invasion

Abstract

Background

Patients with cartilage invasion in hypopharyngeal squamous cell carcinoma (HPSCC) would benefit from partial laryngopharyngectomy (PLP).

Aims/objectives

The purpose of this study was to examine the treatment outcomes of PLP for HPSCC with cartilage invasion, with a focus on the oncological safety and the function preservation.

Materials and methods

We performed a retrospective review of 28 patients with HPSCC with thyroid or cricoid cartilage invasion who had undergone upfront surgery and were followed for more than one year between 1993 and 2019.

Results

Twelve patients treated with PLP (42.9%) and 16 patients treated with total laryngopharyngectomy (TLP) for cartilage invasion in HPSCC were identified. There was no significant difference in recurrence between the PLP group (7/12, 58.3%) and the TLP group (8/16, 50.0%) (p = .718). PLP was not associated with decreased five-year disease free survival (p = .662) or disease specific survival (p = .883) rates compared to TLP. Nine patients receiving PLP could be decannulated and retained intelligible speech (9/12, 75%). Gastrostomy tubes were placed in the PLP group (5/12, 42.9%) and TLP group (1/16, 6.2%) (p = .057).

Conclusions and significance

PLP appears to be a feasible option for the treatment of thyroid or cricoid cartilage invasion in HPSCC.

Chinese Abstract

背景：下咽鳞状细胞癌 (HPSCC) 的软骨浸润患者将受益于部分喉咽切除术 (PLP)。

目的：本研究的目的是检查 PLP对HPSCC伴软骨浸润 的治疗结果, 重点关注肿瘤安全性和功能保存。

材料和方法：我们对 28 名 HPSCC 甲状腺或环状软骨浸润患者进行了回顾性研究。这些患者从 1993 年到 2019 年期间接受过前期手术并随诊超过一年。

结果：确认了12 名接受 PLP 治疗的HPSCC软骨浸润患者 (42.9%) 和 16 名接受全喉咽切除术 (TLP)治疗的患者。 PLP 组 (7/12, 58.3%) 和 TLP 组 (8/16, 50.0%) 的复发率没有显著差异(p=.718)。 与 TLP 相比, PLP 与五年无病生存率(p=.662)或疾病特异性存活率 (p=.883) 的降低无关。 9 名接受 PLP 的患者可能拔管并保留可理解的语音（9/12, 75%）。 胃造口管被置于PLP 组 (5/12, 42.9%) 和 TLP 组 (1/16, 6.2%) (p=.057)。

结论和意义：PLP 似乎是治疗HPSCC伴甲状腺或环状软骨浸润的可行方法。

Keywords:

• Hypopharynx
• squamous cell carcinoma
• reconstructive surgical procedures
• thyroid cartilage
• treatment outcome

Disclosure statement

No potential conflict of interest was reported by the author(s).