Post-cricoid cancer: an overview

Two retrospective studies of post-cricoid cancer are presented: study A, of 283 cases for demographic data, disease pattern, statistics and radiotherapy results; and study B, of 100 surgically treated cases for results of surgery and comparison of three methods of reconstruction. Study A revealed a male:female ratio of 1:2. Thirty-one percent of cases were too advanced at presentation for any form of treatment. Most patients were offered radiation therapy, but 21.7% did not complete it due to nutritional depletion. Disease-free survival (DFS) in patients who completed radiation therapy (137) was 66%, 21%, 4%, and 2% in stages I, II, III, IV respectively. Study group B showed that the DFS following surgery for stages III and IV was 28%. Reconstruction of the gullet by gastric transportation affected early swallowing but had the highest mortality; the pectoral myocutaneous flap method had the lowest mortality but a high leak rate and postoperative stenosis; the deltopectoral flap showed a high leak rate, delayed swallowing, and the longest hospitalisation of all 3 methods. Early diagnosis, nutritional support during radiation therapy, surgery in stages III and IV, and one-stage reconstruction are recommended.