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Primary pharyngolaryngectomy with jejunal free flap reconstruction: a single centre's evolving experience
Author(s) -
Henrys Courtenay,
Slaughter Thomas,
Bernard Anne,
Perry Christopher,
Porceddu Sandro,
Panizza Benedict
Publication year - 2020
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.15930
Subject(s) - medicine , chemoradiotherapy , stage (stratigraphy) , surgery , basal cell , radiation therapy , population , head and neck squamous cell carcinoma , head and neck cancer , paleontology , environmental health , biology
Background Head and neck squamous cell carcinoma, and in particular hypopharyngeal squamous cell carcinoma, has long been associated with disfiguring treatment options, significant morbidity and limited long‐term survival outcomes. Total pharyngolaryngectomy (TPL) with free flap reconstruction followed by post‐operative radiation therapy or chemoradiotherapy is a widely accepted treatment of choice for advanced disease of the hypopharynx. Methods Our unit undertook a 11‐year review of all primary TPL patients aiming to provide an update on survival outcomes, morbidity, post‐operative complications and evolving management strategies. We report one of the largest single‐centre series to date with 89 patients undergoing primary TPL between 2003 and 2013, and compare these outcomes to 180 patients undergoing TPL at the same facility in the previous 23 years. Results Between study periods, we saw a shift in patient population towards higher stage disease (T‐stage 3 or 4 97% 2003–2013; 68% 1979–2002) and increased nodal involvement (node positive 88% 2003–2013; 70% 1979–2002) without a subsequent reduction in 5‐year disease‐specific survival (52% 2003–2013; 52% 1979–2002) or 5‐year overall survival (32% 2003–2013; 33% 1979–2002).