Conservation laryngeal surgery for selected pyriform sinus cancer

Abstract

Aims: This study reports the treatment of a cohort of patients with pyriform sinus squamous cell carcinoma, using conservative surgery and radiotherapy.

Methods: Thirty-four patients with pyriform sinus SCC were treated between 1986 and 2001, using partial laryngopharyngectomy with or without complementary radiotherapy. Seventy-six percent had stage III-IV lesions. Quality of life questionnaire and clinical examination were used for evaluation of laryngeal function.

Results: Conservation surgery was undertaken. All patients underwent neck dissection. Two thirds of the patients received post-operative radiotherapy. Reconstruction was achieved by local muscular flap in 13 cases, radial forearm free flap in 18 and pectoralis major flap in three. Five-year overall and disease-specific survival rates were 50 and 65%, respectively. Successful laryngeal function preservation with local control was achieved in 80% of the patients.

Conclusion: Partial laryngopharyngectomy is a suitable treatment for early and selected advanced stage pyriform sinus carcinoma with a good functional and oncologic outcome.