Conservation laryngeal surgery for selected pyriform sinus cancer. I. Plouin-Gaudon a ,B.Lengele´ b , G. Desuter a , P. Rombaux a , S. Ledeghen a , V.Gre´goire c , M. Hamoir a, * a Department of Head and Neck Surgery, Head and Neck Oncology Program, Universite ´ Catholique de Louvain (U.C.L.), St Luc University Hospital and Cancer Center, Brussels, Belgium b Department of Plastic and Reconstructive Surgery and Human Anatomy Unit, Head and Neck Oncology Program, Universite ´ Catholique de Louvain (U.C.L.), St Luc University Hospital and Cancer Center, Brussels, Belgium c Department of Radiation Oncology, Head and Neck Oncology Program, Universite ´ Catholique de Louvain (U.C.L.), St Luc University Hospital and Cancer Center, Brussels, Belgium Accepted for publication 16 August 2004 Available online 25 September 2004 KEYWORDS Pyriform sinus; Hypopharyngeal carcinoma; Conservation surgery; Radiation therapy; Free flap Abstract Aims. This study reports the treatment of a cohort of patients with pyriform sinus squamous cell carcinoma, using conservative surgery and radiotherapy. Methods. Thirty-four patients with pyriform sinus SCC were treated between 1986 and 2001, using partial laryngopharyngectomy with or without complementary radiotherapy. Seventy-six percent had stage III–IV lesions. Quality of life ques- tionnaire and clinical examination were used for evaluation of laryngeal function. Results. Conservation surgery was undertaken. All patients underwent neck dissection. Two thirds of the patients received post-operative radiotherapy. Reconstruction was achieved by local muscular flap in 13 cases, radial forearm free flap in 18 and pectoralis major flap in three. Five-year overall and disease- specific survival rates were 50 and 65%, respectively. Successful laryngeal function preservation with local control was achieved in 80% of the patients. Conclusion. Partial laryngopharyngectomy is a suitable treatment for early and selected advanced stage pyriform sinus carcinoma with a good functional and oncologic outcome. q 2004 Elsevier Ltd. All rights reserved. Introduction Squamous cell carcinoma of the pyriform sinus has an unfavorable prognosis. Definitive radiation therapy is generally considered an effective thera- peutic approach for T1 and selected T2 pyriform EJSO (2004) 30, 1123–1130 www.ejso.com 0748-7983/$ - see front matter q 2004 Elsevier Ltd. All rights reserved. doi:10.1016/j.ejso.2004.08.011 * Corresponding author. Address: Department of Head and Neck Surgery, Saint-Luc University Hospital, Ave. Hippocrate n8 10, 1200 Brussels, Belgium. Tel.: C32 2 764 1974; fax: C32 2 764 8935. E-mail address: hamoir@orlo.ucl.ac.be (M. Hamoir).