[Hypopharyngeal carcinoma and radical surgery--does such a therapeutic procedure make sense?]

From 1977 to 1983, 49 patients with carcinoma of the hypopharynx were treated, including follow-up, at the ENT clinic of the Zentralkrankenhaus St. Jürgen Strasse in Bremen. Two groups of patients with comparable tumor stage distributions were either treated with a combination of radical surgery and radiotherapy (19 patients), or not operated at all, receiving instead radiotherapy and/or chemotherapy (30 patients). The five-year survival rates (33% and 11% respectively) revealed, albeit at an altogether low level, the superiority of the radical procedure, including total extirpation of the larynx. The recommendation for radical removal of a hypopharyngeal carcinoma must therefore be made on an individual basis and with some reservation. Compromises, such as surgical management of the lymph node metastases without extirpation of the primary tumor, which is then irradiated, or the excision of the primary tumor in combination with partial resection of the larynx, ought to be made when choosing between possible therapeutic alternatives.