A 5-year experience with hypopharyngeal carcinoma in Ain Shams University Hospitals

Abstract

Introduction: Hypopharyngeal carcinomas are highly lethal tumors with a poor prognosis and a 5-year survival generally ranging from 15% to 20%. There are very few reports about these tumors arising in North Africa. This work represents a retrospective study showing the experience of Ain Shams University Hospitals with these tumors along 5 years. Patients and methods: The study included 28 patients with hypopharyngeal carcinoma. Thirteen patients (46.4%) had surgical treatment (10 total laryngopharyngo-esophagectomy with gastric pull-up, one patient had total laryngopharygectomy with repair using pectoralis major flap, two had partial pharyngectomy with total laryngectomy). Fifteen patients (53.6%) were treated with either radical radiotherapy (6), or alternating chemo-radiotherapy (9). Results: Most of the tumors were postcricoid carcinomas (78.6%). Females dominated males with a male to female ratio of 3:4. Most of the patients presented lately (82% were stages III and IV). Kaplan Meier estimate of 2-year survival was 20%, 25%, and 10% for the surgical group, radiotherapy group, and the combined chemo-radiotherapy group, respectively. Survival was better among patients with pyriform fossa tumors than the postcricoid ones (20-month survival 65%, and 20%, respectively). Conclusion: Postcricoid carcinoma comprises the majority of hypopharyngeal tumors in Egypt. Females are more commonly affected by these tumors, especially postcricoid carcinoma. Most of the tumors present late. The life expectancy for patients with these tumors is very poor. Results of the alternating chemo-radiotherapy, in these tumors, are disappointing.