Surgical resection of hypopharyngeal cancer

Abstract

Surgical treatment is the mainstay in the treatment of hypopharyngeal cancer because majority of the tumors presents in an advanced stage and requires combined treatment of surgery and radiotherapy. The extent of resection should be directed by the surgical pathology of the hypopharyngeal cancer. The impact of submucosal tumor extension, thyroid gland infiltration, cartilage invasion, spread to the paratracheal and paraesophageal lymphatic and the occurrence of a second primary tumor in the esophagus should be appreciated. Conservation surgery for hypopharyngeal cancer is feasible in carefully selected patients presented in an early stage. This allows preservation of laryngeal function and construction of a tracheo-pharyngeal shunt for voice rehabilitation. In those patients who need total laryngectomy, the extent of pharyngeal resection with or without esophagectomy should be tailored according to the extent of tumor infiltration. The method of reconstruction, in turn, will depend on the type of pharyngeal defect resulted after resection. Management of the neck is important because of the propensity of spread via the lymphatic. Elective neck treatment is recommended for NO neck. Surgery is effective in achieving local tumor control.