Use of surgery and postoperative radiation in the treatment of advanced squamous cell carcinoma of the pyriform sinus.

Forty-seven patients with very advanced cancer of the pyriform sinus were treated with surgery and immediate postoperative radiation in a planned sequential manner. Eradication of the cancer above the clavicles was obtained in 81% of the patients, with a treatment mortality of 8%. Most of the patients' tumors were resected with primary closure, which obviated the need for complicated reconstructive procedures. The survival rate of 23% at 2 years and the high rate of distant metastasis reflect the aggressive biologic behavior of this cancer. The need to find an adjuvant treatment that will act upon the systemic spread of this cancer is obvious.