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하인두암의 임상적 고찰
Published Online: May 31, 2020
ABSTRACT
Hypopharyngeal cancer is notorious for presenting no symptoms until very late compaired with laryngeal cancer. This characteristic, coupled with the high incidence of early metastasis to regional lymph nodes and of second primary cancer, leads to a poor prognosis.
Author have investigated retrospectively 18 cases of hypopharyngeal carcinoma treated surgically from March 1986 through March 1990 at Pusan National University Hospital for the purpose of improved survival. The results obtained were as follows.
There were 14 piriform sinus (77.8%), 3 postcricoid (16.7%) and 1 posterior wall (5.5% ) carcinoma.
Advanced cases either stage III or IV were the most (88.9%) at the time of diagnosis.
The incidence of lymph node metastasis was 83.3% in all cases, 66.7% in T2, 90.9% in T3 and 100% in T4 cases respretively.
Among 9 total laryngopharyngectomy and/or esophagectomy, 2 cases were reconstructed pharynx using PMMC flap, 2 cases by D-P flap and 1 case by free jejunum and 4 cases who undertaken total laryngopharyngoesophagectomy were reconstructed pharyngoesophagus using stomach 1 case and left colon 3 cases respectively.
As postoperative complication, pharyngocutaneous fistula developed 5 cases (27.8%) and 3 cases were presented in case of primary closure of pharynx without reconstruction. Dysphagia was also developed 5 cases (27.8%), 4 cases were noted in case of primary closure of pharynx without reconstruction.
There were 3 cases of local recurrence and 1 case of neck recurrence and 1 case of distant metastasis.
Overall two year actuarial survival rate was 57.8%.