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==
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]]
* [[Pain during swallowing]]
** [[Hoarseness]] and speaking difficulties
* Disfigurement of the neck or face
** [[Metastasis]]
* Hardening of the skin of the neck
 
* [[Hoarseness]] and speaking ability
* Metastasis  
===Prognosis===
===Prognosis===
* 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>
**[[Prognosis]] of hypopharyngeal cancer is worse than most of the [[head]] and [[neck]] [[cancers]].
**[[Prognosis]] of hypopharyngeal cancer is usually poor.


Squamous cell carcinoma of the hypopharynx carries the worst prognosis of any SCC of the upper aerodigestive tract of the head and neck both because it often presents with advanced disease. Even when prognosis is corrected for stage, hypopharyngeal cancers continue to have poor outcomes.
* 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: 47% 5-year survival
**Stage I-II has a 49.5% 5-year [[survival rate]]
 
**Stage III has a 47.4% 5-year [[survival rate]]
*Stage III-IVb: 30% 5-year survival
**Stage IV has a 18.6% 5-year [[survival rate]]
 
*Stage IVc: 16% 5-year survival
 
Throat cancers can be cured in 90% of patients if detected early. If the cancer has spread to surrounding tissues or lymph nodes in the neck, 50 - 60% of patients can be cured. If the cancer has spread (metastasized) to parts of the body outside the head and neck, the cancer is not curable and treatment is aimed at prolonging and improving quality of life. After treatment, patients generally need therapy to help with speech and swallowing. A small percentage of patients (5%) will not be able to swallow and will need to be fed through a feeding tube


==References==
==References==
{{reflist|2}}
{{reflist|2}}
{{WH}}
{{WS}}
[[Category:Needs content]]
[[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.