International Journal of Head and Neck Surgery

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VOLUME 1 , ISSUE 1 ( January-April, 2010 ) > List of Articles

RESEARCH ARTICLE

Postoperative Radiotherapy in Hypopharyngeal Cancer: Single-institution Outcome Analysis

Gupta Tejpal, Chopra Supriya, Agarwal Jai Prakash, Ghosh-Laskar Sarbani, D'Cruz Anil, Chaturvedi Pankaj, Dinshaw Ketayun

Citation Information : Tejpal G, Supriya C, Prakash AJ, Sarbani G, Anil D, Pankaj C, Ketayun D. Postoperative Radiotherapy in Hypopharyngeal Cancer: Single-institution Outcome Analysis. Int J Head Neck Surg 2010; 1 (1):1-8.

DOI: 10.5005/jp-journals-10001-1001

Published Online: 01-04-2010

Copyright Statement:  Copyright © 2010; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Purpose

To retrospectively review the outcomes of adjuvant postoperative radiotherapy (PORT) following surgery in patients with advanced hypopharyngeal cancer treated at an academic tertiary referral center.

Methods

Data of patients treated with curative intent in a single radiotherapy unit over a 15-year period (1990-2004) with upfront surgery followed by PORT was retrieved from an electronic database. Local control (LC), locoregional control (LRC) and disease-free survival (DFS) were considered as outcome measures.

Results

The study dataset constituted 159 patients with a median age of 55 years (range 30-79 years). Patients underwent either radical surgery (total laryngectomy with or without pharyngectomy) or voice-conserving surgery. All patients underwent appropriate comprehensive neck dissection. The median radiotherapy dose was 60 Gy (inter-quartile range 50-60 Gy). With a mean follow-up of 21 months (inter-quartile range 6-29 months), the 3-year LC, LRC, and DFS was 87.8%, 70.3% and 62.2% respectively. Cut margin negativity and pyriform sinus subsite predicted for improved LRC and DFS on univariate analysis. Cut margin status was the only independent predictor of outcome on multivariate analysis.

Conclusion

Hypopharyngeal cancer characterized by advanced disease at presentation. Definitive surgery (either voice-conserving or radical) followed by adjuvant radiotherapy provides good LRC and DFS and continues to remain a valid upfront treatment option for advanced hypopharyngeal cancer. Cut margin status and primary subsite are important determinants of outcome.


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