OBJECTIVETo evaluate the treatment results of T4 squamous cell carcinoma of the pyriform sinus.

METHODSSixty patients with T4 cancer of the pyriform sinus were included in this retrospective analysis. Fifteen patients were treated with radiotherapy alone (Ra group) with 67.9 Gy. Seven patients were treated with surgery alone (S group) with no laryngeal function sparing surgery. Sixteen patients were treated with preoperative radiotherapy with 49.8 Gy followed by surgery including three cases with laryngeal function sparing surgery (R + S group). Twenty-two patients were treated with surgery followed by postoperative radiotherapy with 58.5 Gy (S + R group), and there was no laryngeal function sparing surgery in this group. The survival rate was calculated using Kaplan-Meier method.

RESULTSThe overall 5-year survival rate for all patients was 32.4%, 8.7% for R group, 33.3% for S group, 29.2% for R+S group, 47.7% for S+R group, 41.7% for combined therapy group (R + S group and S+R group) and 13.6% for single therapy group (S group and R group). There was a statistically significant difference between the two groups (P = 0.02). The overall 5-year survival rates for R + S group and S + R group were 29.2% and 47.7%, respectively, with no significant difference (P = 0.228). Surgery complications for R + S group was 50.0% and 31.8% for S + R group, with no significant difference (P = 0.258).

CONCLUSIONSCombined therapy is the standard treatment modality for T4 squamous cell carcinoma of the pyriform sinus. Surgery with postoperative radiotherapy seems to be more advantageous.