Introduction
Hypopharyngeal cancers have some of the worst outcomes of any head and neck cancers. Features of unresectability can often be difficult to definitively identify on pre-operative imaging, and can make decision making and patient counselling difficult.
The aim of the present study was to examine pre-operative imaging characteristics of hypopharyngeal cancers to determine how well imaging findings predicted surgical resectability.
Methods
A retrospective case-control study of patients undergoing a pharyngo-laryngectomy, either attempted or completed, in a tertiary referral centre between 2012 and 2023 was carried out.
Results
A total of 78 patients met inclusion criteria, of which 71 patients ultimately underwent surgical resection, while 7 patients were deemed unresectable at the time of surgery. Of all 78 cases, 24 cases (30.7%) had radiological suspicion for pre-vertebral fascia invasion, of which 19 cases underwent successful surgical resection, giving a rate of resectability of 79.2%. For carotid artery abutment or encasement and low tracheal invasion the rate of resectability was 78.6% and 87.5% respectively.
Conclusions
This study demonstrated a high rate of resectability of hypopharyngeal cancers with imaging findings suspicious for unresectability. Features of unresectability can be difficult determine on imaging alone. In these patients, especially in the salvage setting where surgery is the only remaining curative-intent treatment option, surgery should be considered.
JM Hintze, E Cleere, J Griffin, I O’Riordan, C Timon, J Kinsella, P Lennon, C Fitzgerald
Department of Otolaryngology, Head and Neck Surgery, St. James’s Hospital