[Effect of tumor size on lymph node metastasis and type of treatment on the prognosis of hypopharyngeal cancer]

Abstract

A retrospective follow-up examination of 117 cases results in: (1) The crude survival rates for 3 resp. 5 years are 19% resp. 15%. If those patients whose cause of death has not been the tumour, are taken into consideration, the crude survival increases to 44.5 resp. 31%. The unfavourable prognosis depends on the enlarged stage of the carcinomas in the moment of diagnosis. (2) The survival chance decreases with increasing tumor size. Much more however it will be affected by the neck node metastases. In our patients the survival rate for pN 1-3 is less by half of pN 0. Therefore not only the TNM-system (UICC) but also the staging (AJC) should be used for the classification of hypopharyngeal carcinomas. (3) The main cause of death are lymph node relapses. The high frequency of contralateral node relapses requires bilateral neck dissection in most of the cases. (4) Combined radio-surgery gives the best results in cases of hypopharyngeal carcinoma, no matter if radiation will be applied pre- or postoperatively. (5) Radiation alone may be useful only in tumours of stage IV. In our opinion, mutilating surgical intervention will not improve the survival chance in these cases.