[Clinical analysis of posterior hypopharyngeal wall squamous cell carcinoma: a report of 36 cases].

BACKGROUND & OBJECTIVE: Posterior hypopharyngeal wall squamous cell carcinoma is few in clinic. This study was to discuss its treatment and the simultaneous reconstruction and function of hypopharyngeal wall. METHODS: Clinical data of 36 posterior hypopharyngeal wall squamous cell carcinoma patients (24 men and 12 women; 4 in stage I, 4 in stage II, 9 in stage III, 19 in stage IV), treated in Cancer Hospital of Chinese Academy of Medical Sciences between Jun. 1967 and Jan. 2000, were retrospectively analyzed. Of the 36 patients, 20 received combined therapy (surgery plus radiotherapy), 10 received radical radiotherapy, 3 received surgery alone, 3 received salvage surgery after failure of radiotherapy (2 at neck, 1 at hypopharynx and neck). Simultaneous reconstruction of hypopharyngeal wall used gastric tissue, jejunum tissue, ileum tissue, musculi pectoralis majoris flap, forearm flap, larynx tissue, gastroepiploic tissue, platysmal flap, and musculus trapezius flap. RESULTS: The 5-year survival rates were 40% in combined therapy group, and 30% in radical radiotherapy group. In surgery alone group, 2 patients were died, and 1 was lost of follow-up. All 3 patients in salvage surgery group were died within 3 years. Of the 24 patients underwent surgery, 4 (17%) underwent local resection, 20 (83%) underwent hypopharyngeal reconstruction; of the 20 patients, 11 (55%) patients used gastric tissue or jejunum tissue, and 9 (45%) patients used other tissues; no patient died during perioperation; the occurrence of complications was 15%; the reconstruction success rate was 85%; the mean time to eating was 2-3 weeks; 3 patients suffered local recurrence. CONCLUSIONS: The combined therapy, emphasized on resume swallow function, has good effect on posterior hypopharyngeal wall squamous cell carcinoma. Simultaneous reconstruction of hypopharynx may resume swallow function without increase of prognosis hazard. Gastric and jejunum tissues are mainly used in reconstruction. Local resection could be applied to some patients to preserve swallow function.