• Radiation Oncology Journal
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• 제11권2호
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• pp.277-283
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• 1993

Background: We peformed a retroslective study in patients with previously untreated advanced (Stage III or IV) laryngeal and hypopharyngeal cancer to compare the results of induction chemotherapy followed by definitive radiation therapy (CT+ RT) with those of conventional laryngectomy and postoperative radiation therapy (OP + RT). Method: Between 1985 and 1990, twenty-four patients were treated with two or three courses of chemotherapy and radiation therapy (66-75 Gy). Twenty-five patients were received laryngectomy and radical neck dissection (except 3 patients) and postoperative radiation therapy (55~64 Gy). Result: After a median fellow-up of 20 months, the actusrial 5-year overall survival rate was $24\%$ (chemotherapy group) and $36\%,$ (op group). (P>0.1). The local control rate was the $65\%,$ (13/20) and $68.2\%,$ (15/22). (p>0.1). The rate of laryngeal preservation was $65\%$ (13/20) in chemotherapy group. Conclusion: Induction chemotherapy and definitive radiation therapy can be effective in preserving the larynx in a high percentage of patients with advanced laryngeal and hypopharyngeal cancer.

• 대한두경부종양학회지
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• 제11권2호
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• pp.158-166
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• 1995

Planning of the skin incision is one of the most important point for safe removal of the head and neck cancer. The fact that so many types of incisions exist is strong testimony that there is hardly one incision that fits all situation. Factors that influence the choice are adequate exposure, changeability to other types of neck dissection, optimal exposure of the primary site and/or opposite side of the neck, and safety of the neck flap and cosmesis. Laryngeal and hypopharyngeal carcinomas are the most common tumor of the head and neck, even though there are so many diverse situation exist, there must be an optimal approach to each case. From 1992 to 1994 surgical approaches used for laryngeal and hypopharyngeal carcinoma at the Severance Hospital were reviewed. Types of surgical approaches, its pitfall, advantage and disadvantages were reviewed.

• 대한두경부종양학회지
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• 제15권1호
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• pp.18-21
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• 1999

Background and Objectives: Occult neck metastasis rate of laryngeal and hypopharyngeal cancer varies widely depending upon authors. Materials and Methods: Sixty four cases, previously untreated, of N0 laryngeal and hypopharyngeal squamous cell carcinoma patients who underwent surgery as an initial treatment from 1992 to 1997 were evaluated. All had unilateral or bilateral elective neck dissection at the time of surgery for the primary. Occult neck metastasis rate was evaluated with pathologic examination of neck dissection specimen. Results: Occult neck metastasis rate by primary site was as follows. Supraglottis ipsilateral 32%(8/25) contralateral 15%(3/20), glottis ipsilateral 17%(5/30), contralateral 0%(0/22), hypopharynx ipsilateral 78%(7/9), contralateral 25%(2/8). Conclusion: Supraglottic and hypopharyngeal cancer may need elective neck treatment bilaterally. Occult neck metastasis of glottic cancer to opposite site was minimal.

• 대한두경부종양학회지
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• 제14권1호
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• pp.46-53
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• 1998

Background: Hypopharyngeal cancer represents about one-third the incidence of laryngeal cancer which is the most common cancer in head and neck area. Although there have been numerous reports regarding its clinical and statistical characteristics, more precise and ample data should be collected and analyzed in this country. Objectives: This study was designed to evaluate the pattern and patient's profile of the hypopharyngeal cancer, and we reviewed the treatment outcomes to search for an index of treatment modalities. Materials and Methods: The authors retrospectively analyzed 73 cases of hypopharyngeal cancer treated at Yonsei Medical Center during the 10-year period from 1985 to 1994. Five-year survival rate was calculated according to the primary site, clinical stage and treatment modality. Results: The incidence was predominated in male by 9 to 1 and peak incidence was 6th and 7th decades. Pyriform sinus was the main primary site(80.8%) followed by posterior hypopharyngeal wall(13.7%) and postcricoid area(5.5%). Advanced stage cancers(87.7%) were more common than early stage cancers. Radiotherapy(60.3%) was the most commonly used as primary treatment modality. Neck node metastasis was early occurred even in early stage cancers(61.5%), and overall rate of neck node metastasis was 69.9%. All surgical cases received procedures more than total laryngectomy and partial pharyngectomy. The most common cause of death was primary failure(81.5%) and it was highest in radiotherapy group. Five-year survival rate was significantly high in surgery group(90.9%). The overall 5-year survival rate of hypopharyngeal cancer was 30.3%. Conclusion: High index of suspicion should be required for early diagnosis. Also, surgery may be recommended for the primary treatment modality in advanced stage cancers.

• Asian Pacific Journal of Cancer Prevention
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• 제16권1호
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• pp.253-258
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• 2015

Background: Development of squamous cell cancer of head and neck (SCCHN) is associated with human papillomavirus (HPV) infection, which in turn is closely related with expression of $p16^{INK4A}$. Loss of $p16^{INK4A}$ expression by deletion, mutation, or hypermethylation is common in SCCHN. We here evaluated $p16^{INK4A}$ as a prognostic marker of treatment response and survival in our SCCHN patients with laryngeal, hypopharyngeal or nasopharyngeal cancers. Materials and Methods: 131 patients diagnosed with SCCHN between January 2,2006 and July 17, 2010 were examined for $p16^{INK4A}$. The median age was 60 years (15-82 years). Fifty one patients were stage I-II and 80 were stage III-IV. Immunohistochemical expression of $p16^{INK4A}$ was analyzed in pretreatment paraffin-embedded tumor blocks. The influence of $p16^{INK4A}$ status on disease-free survival, and overall survival after treatment was evaluated. Results: $p16^{INK4A}$ positivity was found in 58 patients (44%). Tumor-positivity for$ p16^{INK4A}$ was correlated with improved disease free survival (70.1 months vs 59 months) and improved overall survival (2, 3 and 5-year values; 77% vs 72%, 70% vs 63% and, 63% vs 55%; respectively). On multivariate analysis, stage was determined as independent prognostic factor for disease-free survival. Conclusions: Stage was the major prognostic factor on treatment response and survival in our patients. $p16^{INK4A}$ status predicts better outcome in laryngeal, hypopharyngeal or nasopharyngeal cancer cases treated with surgery plus adjuvant radiochemotherapy as well as with definitive radiation therapy and/or chemotherapy.

• 대한두경부종양학회지
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• 제24권2호
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• pp.162-168
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• 2008

Purpose：To know the results after induction chemotherapy followed by curative radiation therapy for locally advanced hypopharyngeal cancer Methods and Materials：From August 1990 to December 2003, forty patients who were treated with induction chemotherapy and curative radiation therapy were analyzed retrospectively. Median age of patients was 60 years(range：40-78 years) and clinical stage was wholly stage 3 or 4. Induction chemotherapy used cisplatin with 5-FU or docetaxel, and its interval was 3 weeks. Irradiated radiation dose was 70 to 78Gy (median：70.8Gy). Results：Median follow-up time was 39.4 months(range：8-115 months). Treatment failures were observed in 52.5% patients, and main failure pattern was local recurrence in 16 patients. 3 and 5 year disease free survival were 52.6%, 48.2% respectively and values of overall survival were 60.0, 43.9% and median survival time was 44.7 months. Treatment response was only a prognostic factor for survival. Laryngeal preservation was observed in twenty-four(60.0%) patients. Conclusion：Initial primary tumor stage was a significant prognostic factor for laryngeal preservation, and response after radiation therapy was a prognostic factor for long-term survival after induction chemotherapy followed by curative radiation therapy for locally advanced hypopharyngeal cancer.

• 대한두경부종양학회:학술대회논문집
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• 대한두경부종양학회 1992년도 제9차 학술대회 연제순서 및 초록집
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• pp.139.1-139.1
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• 1992

• 대한기관식도과학회지
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• 제4권1호
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• pp.43-51
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• 1998

Background： Three-dementional imaging with spiral CT(3D spiral CT) is a well established imaging modality which has been investigated in various clinical settings. However the 3D spiral CT in upper airway disease is rarely reported and its results are still obscure. Objectives： To access the usefulness of 3D spiral CT imaging in patients with upper airway diseases. Materials and Methods We performed 3D spiral CT in fourteen patients In whom upper airway diseases were clinically suspected. Nine of these patients had upper airway stenosis, two had laryngeal cartilage fracture, and three had laryngo-hypopharyngeal cancer. For evaluation of location and extent of the lesions, we compared the findings of 3D imaging with those of air tracheogram, conventional 2D CT images, endoscopic and operative findings. Results： In case of stenosis, 3D spiral CT provide significant useful information, particularly the site and length of the stenotic segment. But, it was difficult to define the fracture of the laryngeal framework and to detect the cartilagenous invasion by head and neck cancer using the 3D imaging. Conclusion : The 3D spiral CT was an useful adjunctive method to assess some kind of upper airway disease but not in others. So, we should compare the findings of 3D images with those of other diagnostic tools for accurate diagnosis of the upper airway disease.

• Journal of Chest Surgery
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• 제24권8호
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• pp.807-813
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• 1991

Between October 1987 and October 1990, 6 patients underwent pharyngolaryngoesophagectomy with transhiatal gastric transposition and pharyngogastrostomy for hypopharyngeal and recurred laryngeal cancer. All patients had squamous cell carcinoma and were male, with age range from 54 to 67 years. Two patients had been treated initially by chemotherapy, but the tumor had persisted. One patient had been treated by radiotherapy and operation, but tumor had recurred in hypopharynx. There was no operative death. Major complications were anastomotic leakage in three cases, wound disruption in four cases and one postoperative bleeding. Anastomotic leakage was recovered in two cases with conservative management. The average hospital day was 33 days postoperatively. We conclude that reconstruction of the pharynx and cervical esophagus with gastric transposition is one of the recommendable procedures for extensive resection of pharynx or cervical esophagus with acceptable morbidity and functional recovery.

• 대한기관식도과학회지
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• 제8권1호
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• pp.75-80
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• 2002

Radiation therapy is an effective treatment modality for malignant disease of the head and neck, but it is not without risk and complication. Response of the larynx to radiotherapy varies from mild erythema to severe inflammation with edema and induration. possibly leading to necrosis of cartilage. These changes are due to an inflammatory reaction characterized by infiltration of polymorphonuclear leukocytes, vascular thrombosis, and obliteration of lymphatic channels. Late changes consist of telangiectasia of the skin, alopecia, loss of subcutaneous fat, degenerative changes in the connective tissues. But, radiation necrosis of laryngeal cartilage is an uncommon complication and it is a devastating process for which further necessitates surgical treatment. It is generally agreed that the only treatment for patient not responding to conservative measures is a total laryngectomy. We experienced 4 cases of delayed radionecrosis of the larynx who underwent radiation therapy for glottic cancer and hypopharyngeal cancer. We report these cases with review of literature.