Radial clearance in resection of hypopharyngeal cancer: an independent prognostic factor.

BACKGROUND

The depth of infiltration of tumor is of particular relevance in hypopharyngeal cancers, because most of them are seen late, and extensive infiltration into the muscle wall and the cartilage are not uncommon.

METHODS

The resected specimens of hypopharyngeal cancers were studied with whole-organ step-serial sectioning. The extent of infiltration into the thickness of the wall and the radial clearance were carefully documented. These parameters were correlated with the tumor recurrence and survival rates.

RESULTS

Most patients with hypopharyngeal cancer had a minimal radial margin; the radial clearance was <1 mm in 56% of the patients. Despite such a minimal margin, the local recurrence rate was only 19% and occurred mainly in the upper and lower resection margins. Radial clearance was an independent prognostic factor for overall survival, disease-free survival, and nodal recurrence-free survival on multivariate analysis.

CONCLUSION

Radial clearance is an important independent prognostic factor, and it is recommended to be included in the routine pathologic reporting of the resected specimen in hypopharyngeal cancer.