[Treatment of carcinoma of the piriform sinus]

Sixty patients with carcinoma of the piriform fossa were treated with surgery and postoperative irradiation, and 22 other patients with incurable disease were irradiated. All but 2 patients primarily irradiated died within a year. 87% of the 60 patients who were treated by primary surgery had histologically proven lymph node metastases. Twenty six of these patients suffered a local recurrence, regional metastases or distant metastases within 18 months. They were all dead within 2 years of diagnosis of the primary tumor. 75% of patients in this group had shown capsular rupture by metastases. Thirty two of the patients operated on are now free of disease, 23 of them for more than 18 months. Eighteen patients had regional metastases, of whom 6 had caused capsular rupture. The tumor specific 3 year survival was 47.1%. Primary radical surgery followed by radiation therapy is the most effective form of treatment for cancer of the piriform sinus, and should always be advised if possible instead of less mutilating but also less effective forms of treatment.