Surgical treatment of pyriform sinus cancer: a retrospective study

Patients with squamous cell carcinoma of the pyriform sinus treated surgically from 1959 through 1979 at the University of California, San Francisco were reviewed. As several reports had previously suggested that the addition of radiation therapy, preoperatively or postoperatively, did not increase survival, our data collection and analysis was performed in such a way as to determine whether similar trends were present in our patients. Data were tabulated for patients having: 1. surgery alone (SA); 2. preoperative radiation and surgery (RS); and 3. surgery and postoperative radiation (SR). The surgery alone group demonstrated the best results, with 65% 3-year determinant survival, and 56% 5-year survival, compared to 50% 3-year and 33% 5-year survivals in the combined groups. In this patient population, the increased death rate in the combined therapy group appeared to be due primarily to a higher distant metastasis rate (50% vs. 26% for the surgery alone group). Although our numbers are too small for any of the comparisons to be significant, the findings of similar cure rates of pyriform sinus cancers by surgery alone support similar data from other authors. As staging was similar in the two groups, and none of the other variables examined appeared to explain these results, we could only conclude that further data is needed, and that the exact role of radiation therapy, in combination with surgery for pyriform sinus cancer remains to be defined.