Carcinoma of the hypopharynx

This article provides an overview of the Toronto experience with carcinoma of the hypopharynx. The symptoms and clinical features of patients presenting with this disease are described. The majority of patients present with either advanced primary tumors or with disease already involving the regional lymph nodes. Survival for all patients presenting with this disease has not changed over a 16 year period. No patients presenting with bilateral or fixed nodal disease achieve five year survival. The results of radical treatment using different approaches are reviewed. Radical radiation therapy with surgery deferred for residual or recurrent disease offers a similar survival to routine combined treatment but preserves laryngeal function in 85% of those who survive five years. The prospects for improving the results of primary radical radiation therapy and our ability to surgically cure patients who fail radiation therapy are discussed.