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 SYMPOSIUM: HEAD AND NECK
Year : 2012  |  Volume : 49  |  Issue : 2  |  Page : 236-244

Early stage squamous cell carcinoma of the pyriform sinus: A review of treatment options


Department of Head and Neck Cancer, University Clinic of Radiotherapy and Oncology, Skopje, Republic of Macedonia

Correspondence Address:
V Krstevska
Department of Head and Neck Cancer, University Clinic of Radiotherapy and Oncology, Skopje
Republic of Macedonia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-509X.102920

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The purpose of this review of the literature was to present treatment options for early stage pyriform sinus cancer. Squamous cell carcinoma of the pyriform sinus, as the most frequent cancer arising from the hypopharynx, is rarely diagnosed in its early stage. Based on evidence from retrospective studies, conservation surgery and definitive radiotherapy are considered the available treatment modalities for patients presenting with stage T1 and T2 pyriform sinus carcinomas without clinical evidence of neck lymph node metastases, offering similar results with respect to disease control and functional organ preservation. Also, the high risk of occult metastatic nodal disease even in the earliest stage of pyriform sinus cancer entails elective neck dissection or elective neck irradiation to be considered mandatory. However, for patients with early stage pyriform sinus cancer, no level 1 study exists in which conservation surgery is compared with radiotherapy alone for the evaluation of local control or survival. Randomized multicenter controlled trials evaluating efficacy of conservation surgery and definitive radiotherapy, and correctly interpreting functional outcome for each of the treatment procedures examined are necessary to obtain sufficient evidence to influence the decision in the choice of the most effective treatment for early pyriform sinus cancer.






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