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6.7.5: 5. AfHNS Guidelines for Evaluation of Hypopharyngeal Cancer- Key Points

  • Page ID
    18388
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    • Histological diagnosis is essential
      • Squamous cell carcinoma (SCC) is most common (rarely adenoid cystic carcinoma, liposarcoma)
      • Exclude inflammatory causes e.g. TB
    • Principal treatment options are surgery +/- adjuvant radiation therapy; or (chemo)radiation
    • Objectives of preoperative evaluation
      • Confirm diagnosis
      • Describe the precise location of the cancer
      • Stage the primary cancer and the neck and exclude distant metastases
      • Decide whether to offer curative or palliative treatment
    • Patient evaluation
      • Unlike cancers of the larynx, patients are often malnourished due to dysphagia and odynophagia
      • Fitness for surgery / chemoradiation
      • Ability to cope with aspiration if partial laryngectomy, chemoradiation considered
      • Ability to complete surgery and postoperative radiation therapy, or chemoradiation
      • Ability to deal with the long-term consequences of treatment e.g. dysphagia, aspiration, tracheostomy, hypothyroidism, voice disturbance/aphonia
    • Surgery
      • Plan appropriate surgery
      • Avoid inappropriate surgery
      • Avoid surgery beyond the scope of the surgeon e.g. complex salvage surgery