CURRENT STATUS OF HYPOPHARYNGEAL CANCER TREATMENT AND LARYNGEAL PRESERVATION SURGERY

• Published in: JIBI INKOKA TEMBO Vol. 63; no. 4; pp. 140 - 151
• Main Author: Matsuura, Kazuto
• Format: Journal Article
• Language: Japanese
• Published: Society of Oto-rhino-laryngology Tokyo 15.08.2020
• Subjects: double cancer; guidelines; hypopharyngeal cancer; laryngeal preservation surgery
• ISSN: 0386-9687; 1883-6429
• DOI: 10.11453/orltokyo.63.4_140

In the treatment of hypopharyngeal cancer, radical irradiation or laryngeal preservation surgery is selected for the purpose of preserving the larynx for early cancer. On the other hand, surgical treatment is the main treatment for advanced cancer, but laryngectomy is often inevitable. Therefore, when conserving the larynx, induction chemotherapy or concurrent chemoradiation therapy is selected.　Patients with hypopharyngeal cancer often have esophageal cancer. If radiation therapy has already been performed for esophageal cancer, it may not be possible for hypopharyngeal cancer. Therefore, laryngeal preservation surgery is an important tactic in the treatment of hypopharyngeal cancer. In recent years, trans-oral surgery and endoscopic laryngo-pharyngeal surgery have been increasing. On the other hand, open laryngeal preservation surgery is rarely performed. Since 2004, we have performed 46 open laryngeal preservation surgery, and were able to obtain a 5-year disease-specific survival rate of 90% and a laryngeal function preservation rate of 83%. Since it was pointed out that it was difficult to determine the resection range, we decided to determine the appropriate resection range using an endoscope. Then, we devised a method of performing a pharyngeal mucosal incision endoscopically and removing the tumor by approaching it from the neck. In this method, complete pathological resection of all cases is obtained, which is considered to be a useful tactic.