N-stage is the most significant prognostic factor in the treatment of cancer of the pyriform sinus (PSC)

Because the prognosis of N2 pyriform sinus cancer (PSC) is poor, this symposium was held on the pertinence of the poor quality of life (QOL) after larygo-pharyngectomy. We analyzed the results of patients with PSC that were treated at our institute between 1980 and 1998. Case numbers were 23 for radical radiotherapy (RT), and 16 for postoperative RT. The local control rate for radical RT for T1-2 was 74.5% at 5 years. Overall survival for N2b PSC after surgery and postoperative RT was 69% at 5 years, whereas that after surgical treatment alone was 28%. The results suggest that surgery and postoperative RT are imperative for N2 PSC. Because of the high local control rate for T1-2 PSC, we divided the treatment modality for T1-2 N+ PSC to achieve laryngeal preservation: neck dissection for cervical metastasis and radiotherapy for primary lesion in 9 patients. One patient developed local recurrence and laryngeal preservation rate was 75% at 5 years. The two-method treatment could be an option for N+ PSC to preserve laryngeal preservation. (author)