Clinico-Pathological Study on Hypo Pharyngeal Carcinoma at Ayub Teaching Hospital Abbottabad

Background: Hypopharyngeal carcinoma is an uncommon but clinically important malignancy of the upper aerodigestive tract and is frequently diagnosed at an advanced stage. However, institution-specific clinicopathological data from Pakistan remain limited. This study was undertaken to describe the demographic, clinical, anatomical, and histopathological characteristics of patients with hypopharyngeal carcinoma presenting to a tertiary-care ENT service in northern Pakistan. Objective: To describe the clinicopathological characteristics of patients with hypopharyngeal carcinoma presenting to Ayub Teaching Hospital, Abbottabad, with particular emphasis on demographic profile, presenting symptoms, primary tumour subsite, histopathological characteristics, cervical lymph-node involvement, and available clinical stage. Methods: A hospital-based cross-sectional study was conducted in the Department of Otorhinolaryngology, Ayub Teaching Hospital, Abbottabad, Khyber Pakhtunkhwa, Pakistan, from 20 January 2025 to 20 May 2025. Patients aged 10–70 years of either sex with histopathologically confirmed hypopharyngeal carcinoma were recruited using non-probability consecutive sampling. Data were collected using a structured proforma and included demographic characteristics, presenting symptoms, tumour subsite, histopathological findings, cervical lymph-node involvement, and clinical stage where available. Data were analysed using IBM SPSS Statistics version 21.0. Continuous variables were assessed for distribution using the Shapiro–Wilk test, while categorical variables were compared using Pearson’s chi-square test or Fisher’s exact test where appropriate. A p-value ≤0.05 was considered statistically significant. Results: A total of 96 patients were included. The median age was 58 years (IQR 51–65), and 78 (81.3%) were male. Tobacco use was documented in 72 (75.0%) patients. Dysphagia was the most common presenting symptom, reported by 82 (85.4%) patients, followed by hoarseness of voice in 39 (40.6%) and neck swelling in 34 (35.4%). The pyriform sinus was the predominant primary tumour subsite, accounting for 69 (71.9%) cases, followed by the posterior pharyngeal wall in 15 (15.6%) and the postcricoid region in 12 (12.5%). Squamous cell carcinoma was the predominant histological type, present in 93 (96.9%) patients. Among these cases, 47 (50.5%) were well differentiated, 34 (36.6%) moderately differentiated, and 12 (12.9%) poorly differentiated. Cervical lymph-node involvement was documented in 61 (63.5%) patients. Clinical staging was available for 88 patients, of whom 72 (81.8%) had stage III or IV disease, including 48 (54.5%) with stage IV disease. No statistically significant associations were observed between the examined demographic/tobacco variables and tumour subsite or cervical lymph-node involvement. Conclusion: Hypopharyngeal carcinoma in this tertiary-care cohort predominantly affected middle-aged and older men and was frequently associated with documented tobacco exposure. Dysphagia was the leading presenting symptom, while the pyriform sinus was the most common tumour subsite and squamous cell carcinoma was overwhelmingly the predominant histological diagnosis. A substantial proportion of patients with available staging information presented with advanced-stage disease, with cervical lymph-node involvement also being common. These findings provide locally relevant clinicopathological data from Ayub Teaching Hospital and reinforce the importance of early recognition and timely diagnostic assessment of suspicious upper aerodigestive symptoms, particularly among patients with relevant tobacco exposure.