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Os tumores da laringe e hipofaringe apresentam alta incidência no Brasil, sendo o sexto sítio mais comum entre os tumores malignos no sexo masculino. O diagnóstico inicial geralmente é realizado com lesões em estadio clínicos avançados diminuindo o sucesso do tratamento instituído. OBJETIVOS: Avaliar a evolução de 60 pacientes com carcinoma epidermóide de seio piriforme, considerando tratamento instituído, complicações e sobrevida estimada em 5 anos. FORMA DE ESTUDO: Estudo retrospectivo. MÉTODO: Os testes estatístico utilizados foram o método de Kaplan-Meier e o teste exato de Fisher. RESULTADOS: Dos 60 pacientes, 43 foram submetidos a tratamento cirúrgico seguido de radioterapia. Atualmente 27,9% estão vivos sem doença, 11,6% vivos com doença, 9,4% mortos sem doença, 34,8% mortos com doença e perda de seguimento de 16,3%. A complicação pós-operatória mais freqüente foi a fístula cutânea. A recidiva local ocorreu em 5 pacientes, regional em 6, loco-regional em 3 e metástase à distância em 6. Não houve correlação entre margem cirúrgica comprometida e sobrevida em 20 pacientes com recidiva tumoral (Teste de Fisher). Aplicando a curva de sobrevida atuarial pelo método Kaplan-Meier, obtivemos média de sobrevida em 5 anos de 23,2 meses. CONCLUSÃO: A principal complicação pós-operatória foi a fístula cutânea, sendo tratada clinicamente. A margem cirúrgica comprometida não alterou o prognóstico, apesar de ser sempre um dos princípios da cirurgia oncológica. A principal falha no tratamento foi a recidiva locorregional. A curva de sobrevida atuarial (Kaplan-Meier) em cinco anos apresentou média de 23,2 meses. Laryngeal and pharyngeal tumors exhibit a high incidence in Brazil, occupying the sixth position as the most frequent cancer sites in males. The initial diagnosis is usually made with the lesion at an advanced clinical stage, hindering success of any treatment employed. AIM: To evaluate the evolution and prognosis of patients with epidermoid carcinoma of the hypopharynx, considering treatment of choice, complications and estimated 5-year survival. STUDY DESIGN: This is a retrospective study METHODS: Using Kaplan-Meier and exact Fisher test. 60 patients with advanced epidermoid carcinoma of the hypopharynx, with the epicenter located at the pyriform sinus, were enrolled. RESULTS: 43 of the 60 patients were submitted to surgical treatment followed by radiotherapy. Currently 27.9% of the patients are alive free of the disease, 11.6% are alive with the disease, 9.4% died from other causes, 34.8% died due to the disease and 16.3% interrupted the follow-up. The most frequent postoperative complication was salivary fistula. Five patients evolved with local recurrence, 6 with regional recurrence, three with loco-regional recurrence and six with distant metastasis. There was no correlation between small surgical safety margins and survival in the 20 patients presenting recurrences (Fisher test). Applying the actuarial survival curve with the Kaplan-Meier method we obtained a 5-year survival average of 23.3 months. CONCLUSION: The major post-surgical complication in hypopharyngeal carcinoma treatment was salivary fistula, being successfully treated without surgery. Small surgical safety margin did not influence the prognosis, even though it is a failure according to one of the fundamental cancer surgery predicaments. The major feature of treatment failure was loco-regional recurrence. The actuarial five-year survival curve (Kaplan-Meier) averaged 23.3 months

Resultado do tratamento cirúrgico das neoplasias do seio piriforme