Determining Factors Which Limit Resectability in Advanced Hypopharyngeal Malignancy.

Area of Science:

• Oncology
• Radiology
• Surgical Oncology

Background:

• Preoperative radiological findings guide surgical resection decisions for hypopharyngeal cancers.
• Assessing the predictive value of imaging characteristics for surgical resectability is crucial.

Purpose of the Study:

• To evaluate how preoperative imaging findings correlate with the surgical resectability of hypopharyngeal cancers.
• To determine the accuracy of imaging in predicting factors that might limit surgical intervention.

Main Methods:

• Retrospective case-control study of 71 patients undergoing pharyngolaryngectomy.
• Collected data included demographics, prior treatments, cancer subsite, TNM staging, and imaging/operative characteristics.

Main Results:

• 91.1% of patients with initial inclusion criteria underwent successful resection.
• Suspicion of prevertebral fascia invasion (30.7%) and carotid artery involvement (17.9%) on imaging did not preclude resection in most cases (79.2% and 78.6% resectable, respectively).
• Suspicious imaging findings for prevertebral fascia invasion were associated with a higher likelihood of close surgical margins.

Conclusions:

• High rates of surgical resectability are achievable for hypopharyngeal cancers, even with preoperative imaging suggesting limited resectability.
• Surgery should be strongly considered for advanced hypopharyngeal cancers, especially in the salvage setting, despite concerning imaging findings.