Radial clearance in resection of hypopharyngeal cancer: An independent prognostic factor

• Published in: Head & neck Vol. 24; no. 2; pp. 181 - 190
• Main Authors: Ho, Chiu M., Ng, Wing F., Lam, Kam H., Wei, William I., Yuen, Anthony P. W.
• Format: Journal Article
• Language: English
• Published: New York John Wiley & Sons, Inc 01.02.2002; John Wiley & Sons
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Female; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Humans; hypopharyngeal cancer; Hypopharyngeal Neoplasms - mortality; Hypopharyngeal Neoplasms - pathology; Hypopharyngeal Neoplasms - surgery; Hypopharynx - pathology; Hypopharynx - surgery; Male; margin; Medical sciences; Middle Aged; multivariate analysis; Neoplasm Invasiveness; Neoplasm Recurrence, Local - pathology; Neoplasm Staging; Otorhinolaryngology. Stomatology; Pharyngectomy; Prognosis; prognostic factor; radial clearance; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the upper aerodigestive tract; survival; Survival Rate; Tropical medicine; Tumors; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology; Hong Kong; Asia; China; Human; Statistical analysis; Prognosis; Treatment efficiency; Stage classification; Surgical resection; Malignant tumor; Multivariate analysis; Survival; TNM-System; Hypopharynx; Treatment; Surgery; ENT disease; Pharynx disease; Predictive factor; Survival curve
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.10002

Background The depth of infiltration of tumor is of particular relevance in hypopharyngeal cancers, because most of them are seen late, and extensive infiltration into the muscle wall and the cartilage are not uncommon. Methods The resected specimens of hypopharyngeal cancers were studied with whole‐organ step‐serial sectioning. The extent of infiltration into the thickness of the wall and the radial clearance were carefully documented. These parameters were correlated with the tumor recurrence and survival rates. Results Most patients with hypopharyngeal cancer had a minimal radial margin; the radial clearance was <1 mm in 56% of the patients. Despite such a minimal margin, the local recurrence rate was only 19% and occurred mainly in the upper and lower resection margins. Radial clearance was an independent prognostic factor for overall survival, disease‐free survival, and nodal recurrence‐free survival on multivariate analysis. Conclusion Radial clearance is an important independent prognostic factor, and it is recommended to be included in the routine pathologic reporting of the resected specimen in hypopharyngeal cancer. © 2002 John Wiley & Sons, Inc.