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The Dilemma of Treating Hypopharyngeal Carcinoma: More or Less
Hayes Martin Lecture
William I. Wei, MS, FRCS, FRCSE, FHKAM
Arch Otolaryngol Head Neck Surg. 2002;128:229-232.
The optimal therapy for hypopharyngeal carcinoma depends on its staging.
For early-stage disease, radiotherapy and surgery achieve similar results.
Radical surgery followed by radiotherapy is applicable in the management of
patients with advanced-stage disease. Chemoradiation aiming to preserve the
larynx can only be performed for selected patients and in well-equipped institutions.
Thorough understanding of pathological behavior of hypopharyngeal carcinoma,
its submucosal tumor extension, and its high propensity to metastasize to
cervical lymph nodes allows head and neck surgeons to choose optimal surgical
treatment. Lymph node status determines the type of neck dissection required
while location and size of the primary tumor determine the extent of resection
and choice of reconstruction procedure. Adequate tumor extirpation with less
extensive and invasive procedures preserving unaffected normal tissue contribute
to more tumor control and less morbidity.
From the Department of Surgery, University of Hong Kong Medical Centre,
Queen Mary Hospital, China.
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