Comprehensive treatment of 335 patients with pyriform sinus carcinoma by surgery via the paraglottic space approach

Wenming LI; Dongmin WEI; Ye QIAN; Shengda CAO; Ya XU; Dayu LIU; Dapeng LEI; Xinliang PAN

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Comprehensive treatment of 335 patients with pyriform sinus carcinoma by surgery via the paraglottic space approach

VernacularTitle: 335例经声门旁间隙入路切除梨状窝癌的疗效分析
Author: Wenming LI ^{1
,

2} ; Dongmin WEI ^{1
,

2} ; Ye QIAN ^{1
,

2} ; Shengda CAO ^{1
,

2} ; Ya XU ^{1
,

2} ; Dayu LIU ^{1
,

2} ; Dapeng LEI ^{1
,

2} ; Xinliang PAN ^{1
,

2}
Author Information

1. Department of Otorhinolaryngology Head and Neck Surgery, Qilu Hospital of Shandong University
2. Key Laboratory of Otorhinolaryngology, National Health Commission(Shandong University), Jinan 250012, China
Publication Type:Journal Article
Keywords: Hypopharyngeal neoplasms; Laryngectomy; Pharyngectomy; Combined modality therapy; Carcinoma, squamous cell
From: Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2018;53(5):339-345
CountryChina
Language:Chinese
Abstract: Objective:To report the experience in comprehensive surgical treatment of pyriform sinus carcinoma via the paraglottic space approach.
Methods:Three hundred and thirty-five cases with pyriform sinus carcinoma (according to UICC 2012 criteria, stage Ⅰ, 12 cases; Ⅱ, 36; Ⅲ, 79; Ⅳ, 208; T1, 26; T2, 139; T3, 121; T4, 49; cN0, 83; cN1, 61; cN2a-b, 118; cN2c, 71; cN3, 2) treated between 2006 and 2013 were retrospectively reviewed. There were 323 males and 12 females. Age aged from 36 to 80 years old with a median of 60 years old. There was no case with distant metastasis. All patients received modified neck dissection, including unilateral in 240 patients and bilateral in 95 patients. Pharyngoesophageal defects were reconstructed with directly suture in 246 cases, pectoralis major musculocutaneous flaps in 74 cases, and laryngotracheal flaps in 15 cases. Three hundred and nineteen patients received postoperative radiotherapy (55-65 Gy).
Results:The overall 3 and 5 year survival rates were 68.6% (230/335) and 52.1%(139/267), respectively. The cervical lymph node metastases were found in 265 (79.1%) patients. Pathologic findings showed that all patients had squamous cell carcinoma. Laryngeal functions (voice, respiration and deglutition) were completely restored in 277 (82.7%) patients.
Conclusions:The oncological efficacy of surgery via the paraglottic space approach is sure for pyriform sinus carcinoma, especially suitable for the early and medium-term lesions. The function of the larynx can retain after surgery, with the decreased incidences of cough and pharynx fistula.