Hypopharyngeal cancer natural history, complications and prognosis: Difference between revisions

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{{Hypopharyngeal cancer}}
{{Hypopharyngeal cancer}}
{{CMG}} {{AE}}{{Faizan}}
{{CMG}}; {{AE}} {{G.D.}}, {{Faizan}}
==Overview==
==Overview==
If left untreated, hypopharyngeal cancer produces few symptoms early in its course. Once the [[tumor]] has expanded from its site of origin, it may obstruct the aerodigestive tract. Common complications of hypopharyngeal cancer include [[airway obstruction]], [[dysphagia]], [[odynophagia]], and disfigurement of the neck or face. The prognosis varies with the type of hypopharyngeal cancer. Squamous cell carcinoma of hypopharynx has the most unfavorable prognosis.<ref name=aaa>Treatment and prognosis. Dr Aditya Shetty and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/hypopharyngeal-squamous-cell-carcinoma</ref>
The majority of patients with hypopharyngeal cancer are [[asymptomatic]] at the initial stages. The majority of patients with hypopharyngeal cancer clinically manifest [[symptoms]] at late stages (III and IV) because of the aggresive nature of [[tumor]] which [[Metastasis|metastasizes]] to [[lymph nodes]] and [[submucosa]]. Once the [[tumor]] has expanded from its site of [[origin]], it may obstruct the [[Digestive|aerodigestive]] [[tract]]. Most common clinical presentations include [[neck]] [[mass]], [[dysphagia]] with [[weight loss]], non healing [[sore throat]], [[odynophagia]], and [[hoarseness]]. Common complications of hypopharyngeal cancer include upper [[airway obstruction]] and disfigurement of the [[neck]] or [[face]]. The [[prognosis]] varies with the type of hypopharyngeal cancer. [[Squamous]] [[cell]] [[carcinoma]] of [[hypopharynx]] has poor [[prognosis]] and small [[survival rate]].


==Natural History, Complications and Prognosis==
==Natural History, Complications and Prognosis==
===Natural History===
===Natural History===
*If left untreated, hypopharyngeal cancer produces few symptoms early in its course.
*The majority of patients with hypopharyngeal cancer are [[asymptomatic]] at the initial stages.<ref name="PracyLoughran2016">{{cite journal|last1=Pracy|first1=P|last2=Loughran|first2=S|last3=Good|first3=J|last4=Parmar|first4=S|last5=Goranova|first5=R|title=Hypopharyngeal cancer: United Kingdom National Multidisciplinary Guidelines|journal=The Journal of Laryngology & Otology|volume=130|issue=S2|year=2016|pages=S104–S110|issn=0022-2151|doi=10.1017/S0022215116000529}}</ref>
*Once the [[tumor]] has expanded from its site of origin, it may obstruct the aerodigestive passages.
*The majority of patients with hypopharyngeal cancer manifest [[symptoms]] at a late stages.<ref name="ZbarenBecker1997">{{cite journal|last1=Zbaren|first1=P.|last2=Becker|first2=M.|last3=Lang|first3=H.|title=Pretherapeutic Staging of Hypopharyngeal Carcinoma: Clinical Findings, Computed Tomography, and Magnetic Resonance Imaging Compared With Histopathologic Evaluation|journal=Archives of Otolaryngology - Head and Neck Surgery|volume=123|issue=9|year=1997|pages=908–913|issn=0886-4470|doi=10.1001/archotol.1997.01900090016003}}</ref>
*Approiximately more than 50% of patients presents with [[neck]] [[mass]].
*Once the [[tumor]] has expanded from its site of [[origin]], it may obstruct the [[Digestive|aerodigestive]] passages.
*The majority of patients with hypopharyngeal cancer may develop distant [[metastasis]] to [[lungs]], [[mediastinum]], [[bones]], [[esophagus]], and [[thyroid gland]].


===Complications===
===Complications===
Common complications of hypopharyngeal cancer include:
* Common complications of hypopharyngeal cancer include:<ref name="PracyLoughran2016">{{cite journal|last1=Pracy|first1=P|last2=Loughran|first2=S|last3=Good|first3=J|last4=Parmar|first4=S|last5=Goranova|first5=R|title=Hypopharyngeal cancer: United Kingdom National Multidisciplinary Guidelines|journal=The Journal of Laryngology & Otology|volume=130|issue=S2|year=2016|pages=S104–S110|issn=0022-2151|doi=10.1017/S0022215116000529}}</ref>
* [[Airway obstruction]]
** [[Airway obstruction]]
* [[Dysphagia]]
** Disfigurement of the [[neck]] or [[face]]
* [[Odynophagia]]
** [[Hoarseness]] and speaking difficulties
* Disfigurement of the neck or face
** [[Metastasis]]
* Hardening of the skin of the neck
* [[Hoarseness]] and speaking inability
* [[Metastasis]]


===Prognosis===
===Prognosis===
The prognosis varies with the type of hypopharyngeal cancer. Squamous cell carcinoma of hypopharynx has the most unfavorable prognosis.<ref name=aaa>Treatment and prognosis. Dr Aditya Shetty and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/hypopharyngeal-squamous-cell-carcinoma</ref>
* The [[prognosis]] of hypopharyngeal cancer depends on the [[age]], [[tumor]] location, [[risk factors]], and the stage.<ref name="pmid12560383">{{cite journal |vauthors=Helliwell TR |title=acp Best Practice No 169. Evidence based pathology: squamous carcinoma of the hypopharynx |journal=J. Clin. Pathol. |volume=56 |issue=2 |pages=81–5 |date=February 2003 |pmid=12560383 |pmc=1769882 |doi= |url=}}</ref><ref name="pmid20925962">{{cite journal |vauthors=Chang MF, Wang HM, Kang CJ, Huang SF, Lin CY, Fang KH, Chen EY, Chen IH, Liao CT, Chang JT |title=Treatment results for hypopharyngeal cancer by different treatment strategies and its secondary primary--an experience in Taiwan |journal=Radiat Oncol |volume=5 |issue= |pages=91 |date=October 2010 |pmid=20925962 |pmc=2958972 |doi=10.1186/1748-717X-5-91 |url=}}</ref>
Based on staging, the 5-year survival rate of hypopharyngeal cancer is as follows:
**[[Prognosis]] of hypopharyngeal cancer is worse than most of the [[head]] and [[neck]] [[cancers]].
*Stage I-II has a 47% 5-year survival rate
**[[Prognosis]] of hypopharyngeal cancer is usually poor.
*Stage III-IVb has a 30% 5-year survival rate
 
*Stage IVc has a 16% 5-year survival rate
* Based on staging, the 5-year [[survival rate]] of hypopharyngeal cancer is as follows:<ref name="pmid20925962">{{cite journal |vauthors=Chang MF, Wang HM, Kang CJ, Huang SF, Lin CY, Fang KH, Chen EY, Chen IH, Liao CT, Chang JT |title=Treatment results for hypopharyngeal cancer by different treatment strategies and its secondary primary--an experience in Taiwan |journal=Radiat Oncol |volume=5 |issue= |pages=91 |date=October 2010 |pmid=20925962 |pmc=2958972 |doi=10.1186/1748-717X-5-91 |url=}}</ref>
**Overall 5 year [[survival rate]] is 24.8%
**Stage I-II has a 49.5% 5-year [[survival rate]]
**Stage III has a 47.4% 5-year [[survival rate]]
**Stage IV has a 18.6% 5-year [[survival rate]]


==References==
==References==
{{reflist|1}}
{{reflist|2}}
 
{{WH}}
{{WS}}
 
[[Category:Types of cancer]]

Latest revision as of 16:58, 24 January 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Gertrude Djouka, M.D.[2], Faizan Sheraz, M.D. [3]

Overview

The majority of patients with hypopharyngeal cancer are asymptomatic at the initial stages. The majority of patients with hypopharyngeal cancer clinically manifest symptoms at late stages (III and IV) because of the aggresive nature of tumor which metastasizes to lymph nodes and submucosa. Once the tumor has expanded from its site of origin, it may obstruct the aerodigestive tract. Most common clinical presentations include neck mass, dysphagia with weight loss, non healing sore throat, odynophagia, and hoarseness. Common complications of hypopharyngeal cancer include upper airway obstruction and disfigurement of the neck or face. The prognosis varies with the type of hypopharyngeal cancer. Squamous cell carcinoma of hypopharynx has poor prognosis and small survival rate.

Natural History, Complications and Prognosis

Natural History

Complications

Prognosis

References

  1. 1.0 1.1 Pracy, P; Loughran, S; Good, J; Parmar, S; Goranova, R (2016). "Hypopharyngeal cancer: United Kingdom National Multidisciplinary Guidelines". The Journal of Laryngology & Otology. 130 (S2): S104–S110. doi:10.1017/S0022215116000529. ISSN 0022-2151.
  2. Zbaren, P.; Becker, M.; Lang, H. (1997). "Pretherapeutic Staging of Hypopharyngeal Carcinoma: Clinical Findings, Computed Tomography, and Magnetic Resonance Imaging Compared With Histopathologic Evaluation". Archives of Otolaryngology - Head and Neck Surgery. 123 (9): 908–913. doi:10.1001/archotol.1997.01900090016003. ISSN 0886-4470.
  3. Helliwell TR (February 2003). "acp Best Practice No 169. Evidence based pathology: squamous carcinoma of the hypopharynx". J. Clin. Pathol. 56 (2): 81–5. PMC 1769882. PMID 12560383.
  4. 4.0 4.1 Chang MF, Wang HM, Kang CJ, Huang SF, Lin CY, Fang KH, Chen EY, Chen IH, Liao CT, Chang JT (October 2010). "Treatment results for hypopharyngeal cancer by different treatment strategies and its secondary primary--an experience in Taiwan". Radiat Oncol. 5: 91. doi:10.1186/1748-717X-5-91. PMC 2958972. PMID 20925962.