Current trends in initial management of hypopharyngeal cancer: The declining use of open surgery

摘要: Squamous cell carcinoma of the hypopharynx represents a distinct clinical entity. Most patients present with significant comorbidities and advanced-stage disease. The overall survival is relatively poor because high rates regional distant metastasis at presentation or early in course A multidisciplinary approach crucial management these to achieve best results maintain improve functional results. Traditionally, operable hypopharyngeal cancer has been treated by total (occasionally partial) laryngectomy partial circumferential pharyngectomy, followed reconstruction postoperative radiotherapy most cases. Efforts preserve speech swallowing function surgical treatment (and laryngeal) have resulted declining use laryngopharyngectomy improved reconstructive efforts, including microvascular free tissue transfer. There are many surgical, as well nonsurgical, options available for organ preservation, which report equally effective tumor control survival. selection appropriate importance achievement optimal patients. In this article, several aspects nonsurgical approaches discussed. Future studies must be carefully designed within clearly defined populations uniform terminology standardized assessment declare patient disease endpoints. These should focus on improvement results, without increasing morbidity. respect, technical improvements such intensity-modulated radiotherapy, advances supportive care, incorporation newer systemic agents targeted therapy, relevant developments.