Results after intensified therapy for advanced carcinoma of the hypopharynx

We conducted a retrospective chart review of 85 patients (95% male) with advanced but resectable hypopharyngeal carcinoma to evaluate the effectiveness of an intensified multimodal treatment protocol. This protocol involved concomitant chemo- and radiotherapy before and after total laryngectomy, partial pharyngectomy, and radical neck dissection. Our study population was divided into two groups on the basis of extrasurgical therapy. Group A was made up of 19 patients who had received only postlaryngectomy radiotherapy; 6 of these patients had a stage III tumor and 13 had a stage IV tumor. Group B included 66 patients who had received the intensified treatment; 1 patient had stage II disease, 12 had stage III disease, and 53 had stage IV disease. We found no significant differences in 5-year survival (p = 0.86) or in disease-free interval (p = 0.57) between group A and group B; median survival was 45 and 50 months, respectively. Likewise, when we analyzed the patients in both groups according to tumor stage (stage III vs. stage IV), we found no significant differences in either 5-year survival (group A: p = 0.95; group B: p = 0.18) or disease-free interval (group A: p = 0.74; group B: p = 0.17). We conclude that the prognosis of advanced hypopharyngeal carcinoma remains poor despite treatment with an intensified multimodality protocol. Therefore, the therapeutic strategy should be to individualize treatment with the goal of preserving laryngeal function and optimizing postoperative quality of life.