Preoperative irradiation in the treatment of carcinoma of the hypopharynx

The results of treatment of 230 cases of carcinoma of the hypopharynx seen at the University of Toronto and the Princess Margaret Hospital, between the years 1951 and 1963, are presented. The recommendations of the American Joint Committee have been followed in the classification of these tumours: 127 of the 230 were located in the pyriform sinuses.The overall five-year survival rate for lesions of the pyriform sinus was 9% as opposed to 20% for tumours in the other regions of the hypopharynx. Surgical treatment alone was used in 44 of these cases, and the five-year net survival figure was 23%. This compared favourably with the overall survival figure of 8% for those treated primarily by radiotherapy.Elective preoperative irradiation leads to improved survival rates. Palliation for Stage IV lesions should be achieved by radiography. The two-stage method of surgical reconstruction remains the surgical procedure of choice despite current enthusiasm for the use of visceral transplants.