BACKGROUND: Squamous cell carcinoma (SCC) in the pharyngoesophageal junction (PEJ) with concomitant involvement of both the hypopharynx and cervical esophagus occurs rarely and poses a challenge in treatment. Data regarding the long-term result of aggressive surgical management was lacking. METHODS: Forty-one consecutive patients were treated with total pharyngolaryngo-esophagectomy (PLE) and reconstruction between 1984 and 2002. The clinicopathological parameters and prognostic data were analyzed. RESULTS: The surgery carried a postoperative mortality rate of 9.8%. The overall median survival was 18.5 months, with a 31.5% 5-year survival rate. By multivariate analysis, patients with major tumor localization in the hypopharynx had significantly favorable prognosis (median survivals for hypopharyngeal versus esophageal localization, 37.2 versus 7.1 months, P = 0.043). The administration of adjuvant radiotherapy and tumor size less than 5 cm also contributed to a better outcome (P = 0.001 and P = 0.037, respectively). CONCLUSIONS: An aggressive surgical approach with total PLE in conjunction with adjuvant radiotherapy represents a feasible option for treatment of advanced SCC simultaneously involving the hypopharynx and cervical esophagus, given the major tumor localization in the hypopharynx. On the other hand, radical surgery for those with major esophageal localization or with tumor size larger than 5 cm yielded ominous results and warrants further justification. Copyright 2006 Wiley-Liss, Inc.
BACKGROUND:Squamous cell carcinoma (SCC) in the pharyngoesophageal junction (PEJ) with concomitant involvement of both the hypopharynx and cervical esophagus occurs rarely and poses a challenge in treatment. Data regarding the long-term result of aggressive surgical management was lacking. METHODS: Forty-one consecutive patients were treated with total pharyngolaryngo-esophagectomy (PLE) and reconstruction between 1984 and 2002. The clinicopathological parameters and prognostic data were analyzed. RESULTS: The surgery carried a postoperative mortality rate of 9.8%. The overall median survival was 18.5 months, with a 31.5% 5-year survival rate. By multivariate analysis, patients with major tumor localization in the hypopharynx had significantly favorable prognosis (median survivals for hypopharyngeal versus esophageal localization, 37.2 versus 7.1 months, P = 0.043). The administration of adjuvant radiotherapy and tumor size less than 5 cm also contributed to a better outcome (P = 0.001 and P = 0.037, respectively). CONCLUSIONS: An aggressive surgical approach with total PLE in conjunction with adjuvant radiotherapy represents a feasible option for treatment of advanced SCC simultaneously involving the hypopharynx and cervical esophagus, given the major tumor localization in the hypopharynx. On the other hand, radical surgery for those with major esophageal localization or with tumor size larger than 5 cm yielded ominous results and warrants further justification. Copyright 2006 Wiley-Liss, Inc.
Authors: Armando De Virgilio; Andrea Costantino; Carlo Castoro; Giuseppe Spriano; Bianca Maria Festa; Giuseppe Mercante; Davide Franceschini; Ciro Franzese; Marta Scorsetti; Andrea Marrari; Raffaele Cavina; Salvatore Marano Journal: J Cancer Res Clin Oncol Date: 2022-03-02 Impact factor: 4.553
Authors: Armando De Virgilio; Andrea Costantino; Carlo Castoro; Giuseppe Spriano; Bianca Maria Festa; Giuseppe Mercante; Davide Franceschini; Ciro Franzese; Marta Scorsetti; Andrea Marrari; Raffaele Cavina; Salvatore Marano Journal: Eur Arch Otorhinolaryngol Date: 2022-08-15 Impact factor: 3.236
Authors: Peter Panhofer; Christopher Springer; Barbara Izay; Matthäus Grasl; Martin Burian; Sebastian F Schoppmann; Thomas Rath; Raimund Jakesz; Johannes Zacherl Journal: Langenbecks Arch Surg Date: 2012-09-02 Impact factor: 3.445