Clinico-pathological Study on Pharyngolaryngoesophagectomy without Thoracotomy for Carcinoma of the Hypopharynx and the Cervical Esophagus -Analysis of 33 Cases-

Katsunori Aoki, Nobuhiko Nishino, Hiroyuki Konno, Hiroshi Maruo, Tatsuro Tanaka, Shozo Baba

The Second Department of Surgery, Hamamatsu University School of Medicine

During the last 13 years, radical operations including cervical dissection, total esophagectomy without thoracotomy, total laryngectomy, pharyngogastric or colonic anastomosis and intensive adjuvant therapy before and after surgery were performed for 33 patients in our hospital. Tweleve of them had carcinoma of the hypopharynx (Group A) (pyriform sinus type, 7; posterior wall type, 3; postcricoid type, 2), 12 had carcinoma involving the hypopharynx and cervical esophagus (Group B) (Ph>Ce, 8; Ph<Ce, 4), and 9 had carcinoma of the cervical esophagus (Group C). Seven of the carcinomas were classified as stage I, five as stage II, six as stage III, and 15 as stage IV. Four patients had the complication of synchronous double cancer of the hypopharynx (pyriform sinus) and esophagus (Im). Although the overall hospital mortality was 6.1% (2/33), the postoperative course of the rest of the patients was uneventful and the patients were discharged in improved condition. The overall 5-year survival rate was 37.9% (44.4% for Group A, 18.2% for Group B, and 55.6% for Group C). The most common cause of long-term failure in Group B was local recurrence at the root of the skull. Improvement in survival may therefore require extensive multidisciplinary treatment directed to the retropharyngeal space in this group.

Key words
carcinoma of hypopharynx, carcinoma of cervical esophagus, esophagectomy without thoracotomy, synchronous double cancer of hypopharynx, radiotherapy

Reprint requests
Katsunori Aoki The Second Department of Surgery, Hamamatsu University School of Medicine
3600 Handa-cho, Hamamatsu, 431-31 JAPAN

Accepted
November 20, 1991

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