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Hypopharynx cancer continues to pose a clinically challenging head and neck subsite, driven not only by the unique set of patient, anatomic and disease factors but also by the paucity of robust clinical data to guide clinical decision making. The standard of care of radical surgery (pharyngolaryngectomy) in combination with postoperative radiotherapy was the previously accepted norm in the setting of advanced hypopharynx cancer, but this was often at the expense of significant morbidity. In the absence of survival benefit for advanced staged disease with radical surgical approaches, over the last 2 decades, the philosophy of quality of life in survivors has driven the agenda for new therapeutic approaches. The adoption of functional larynx preservation strategies has seen a paradigm shift in the treatment of this subsite since the 1990s with the advent of chemoradiation and intensity-modulated radiotherapy, thereby introducing a reducing trend for radical surgery. However, radical surgery (pharyngolaryngectomy) has a role in the non-functioning larynx (either pre- or post-treatment), in advanced volume disease and the more technically challenging salvage setting because of residual or recurrent disease. In earlier stage disease, transoral laser microsurgery and robotic surgery have shown good oncological benefits. Crucially, determining appropriate personalised treatment decisions in this challenging cohort of patients requires discussion within a multidisciplinary team framework.
This article was published in the following journal.
Name: Advances in oto-rhino-laryngology
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Tumors or cancer of the HYPOPHARYNX.
Radiotherapy given to augment some other form of treatment such as surgery or chemotherapy. Adjuvant radiotherapy is commonly used in the therapy of cancer and can be administered before or after the primary treatment.
Drug therapy given to augment or stimulate some other form of treatment such as surgery or radiation therapy. Adjuvant chemotherapy is commonly used in the therapy of cancer and can be administered before or after the primary treatment.
A cancer registry mandated under the National Cancer Act of 1971 to operate and maintain a population-based cancer reporting system, reporting periodically estimates of cancer incidence and mortality in the United States. The Surveillance, Epidemiology, and End Results (SEER) Program is a continuing project of the National Cancer Institute of the National Institutes of Health. Among its goals, in addition to assembling and reporting cancer statistics, are the monitoring of annual cancer incident trends and the promoting of studies designed to identify factors amenable to cancer control interventions. (From National Cancer Institute, NIH Publication No. 91-3074, October 1990)
An internationally recognized set of published rules used for evaluation of cancer treatment that define when tumors found in cancer patients improve, worsen, or remain stable during treatment. These criteria are based specifically on the response of the tumor(s) to treatment, and not on the overall health status of the patient resulting from treatment.
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