Treatment of Hypopharyngeal Carcinoma: A Retrospective Analysis over a 16-Year Period

This retrospective study reviewed a group of 187 hypopharyngeal cancer patients treated in National Taiwan University Hospital (NTUH) over the 16-year period from 1977 to 1992. Patients were grouped according to the American Joint Committee on Cancer (AJCC) staging system. Among the 187 patients, only 9 (5%) were categorized as early stage (I + II) the remaining 178 patients (95%) were categorized as advanced stage (III + IV). A majority of the patients (89 patients) were treated by radical radiation therapy (R/T); 54 patients, by operation followed by radiation therapy (Op + R/T) and 20 patients, by operation alone (Op). The remainder were treated with a combination of three treatment modalities (chemotherapy, operation or radiotherapy). Overall three-year and five-year survival rates were 26.9% and 19.8%, respectively. Three-year survival rates in the advanced stage patients managed by different treatment modalities were: R/T alone, 21.5%; Op, was 23.4%; Op + R/T was 30.2%. Combined Op and R/ T had a statistically improved survival rate (p＜0.01). Local recurrence rate: R/T alone was 36%; Op was 60% and Op + R/T was 37%. On the basis of these results, the survival rate was increased and the local recurrence rate, decreased by combined therapy. However, treatment outcomes in hypopharyngeal cancer remain unfavorable, even with a combination of surgery and radiation therapy. Alternative approaches should be actively investigated to improve survival.