Surgical Treatment of Carcinoma of the Pyriform Sinus

Carcinoma of the pyriform sinus is a highly malignant disease with a generally poor prognosis. A series of 22 carefully selected cases were treated by partial laryngopharyngectomy with radical neck dissection in continuity with an overall survival rate of 54.5% at five years. Total laryngectomy and permanent tracheostomy were avoided. Combined therapy with radiation preoperatively or postoperatively was used in six of the cases with inconclusive results. It is concluded that these patients should be aggressively staged and treated without delay. When this is done and the criteria for surgery closely observed, a better-than-half five-year survival can be obtained without sacrificing the larynx.