Original Research Article
Year: 2018 | Month: May | Volume: 8 | Issue: 5 | Pages: 104-110
Surgical Management of Laryngeal and Hypopharyngeal Cancer in a Tertiary Care Centre
Krishnappa R, Akshatha Shivakumar
Department of Head &Neck Oncology, Kidwai Memorial Institute of Oncology. Bengaluru, India.
Corresponding Author: Akshatha Shivakumar
Background: Despite advances in techniques and dose regulation of chemoradiotherapy, surgery still plays great role in treating large fraction of well selected locally advanced laryngeal and hypopharyngeal carcinoma.
Materials and Methods: A retrospective study of 210 cases of surgically treated laryngeal and hypopharyngeal carcinomas from 2014 to 2015 was analysed.
Results: The most common sub site of involvement was hypopharynx (53.3%) followed by glottis (24.7%), supraglottis (15.7%), transglottic malignancy (4.7%), subglottis (0.95%), and for medullary carcinoma of the thyroid(0.47%) respectively. Total laryngectomy was carried out for 162 patients, 180 0f them required Modified radical neck dissection along with laryngectomy. Near total laryngectomy was done in 28 cases. Post-operative hospital stay was for an average of 14 days (range 10-33) after surgery. Histopathologically squamous cell carcinoma was the most common and 2 patients had spindle cell tumour. 180 patients were referred for adjuvant therapy with RT and of which 120 received both chemotherapy and radiotherapy and 60 defaulted from adjuvant therapy. Recurrences were noted both locoregionally and distant in 13.3% of cases. The mean follow up period was 15 months ranging from 2 months to 25 months.
Conclusion: Surgical modality as definitive treatment in well selected Indian population with locally advanced stage III and IV laryngeal and hypopharyngeal carcinomas, with adjuvant therapy when indicated, is a valuable option with less complications and morbidity achieving acceptable locoregional control. A regular follow up is warranted to detect the early locoregional and distant failures.
Key words: Carcinoma larynx, Carcinoma hypopharynx, Total laryngectomy