TREATMENT OUTCOMES OF LARYNGEAL AND HYPOPHARYNGEAL SQUAMOUS CELL CARCINOMAS IN A TERTIARY CARE CENTER OF NEPAL

Abstract

Objectives:

To analyze the treatment outcomes in patients with laryngeal and hypopharyngeal cancers using locally recurrent or residual disease as an outcome measure.

Materials And Methods:

Data for the observational study was obtained from the Cancer Registration Forms and Register of the Department of E.N.T. and Head Neck Surgery of T.U. Teaching Hospital, Maharajgunj. Patients with histopathologically proven squamous cell carcinomas of larynx and hypopharyx with a minimum follow up duration of 6 months were included in the study. Treatment outcomes were assessed as patients having recurrent/ residual disease or not. Data was analysed using percentages.

Results:

Of the 74 patients included in the study 12% were females and 88% were males. The mean age was 60.82 years. The mean follow up duration was 37.7 months. Majority, 38% had carcinoma glottis. 59.5% of the patients were detected in the advanced stage of disease. Overall, recurrenct/ residual tumour was seen in 13.3% of the early stage disease group whereas recurrent or residual disease was seen in 25% of the advanced stage tumour group. Recurrent/ residual disease was found in 31.8% of the patients that were treated with CT/RT as their primary treatment modality.

Conclusion:

Recurrence rate for squamous cell carcinomas of the larynx and hypopharynx in early as well as advanced stages was found to be higher in the current study as compared to the data available from other parts of the world. The rate was observed to be higher in those treated with chemoradiation as their primary treatment modality. This leads to the question as to whether treatment modalities other than chemoradiotherapy should be adopted especially in the treatment of early laryngeal and hypopharyngeal cancers. Conservative endolaryngeal surgery may be a good alternative to radiotherapy for the treatment of early laryngeal cancers. However, a larger multicentric study needs to be conducted.

Keywords: Chemoradation, Recurrence, Squamous cell carcinoma