Treatment of early (stage I and II) head and neck cancer: The hypopharynx
- Suisui Song, MD
Suisui Song, MD
- Assistant Professor
- University of Southern California/Norris Cancer Center
- Department of Radiation Oncology
- Joseph K Salama, MD
Joseph K Salama, MD
- Associate Professor
- Department of Radiation Oncology
- Duke University Cancer Institute
- James W Rocco, MD, PhD, FACS
James W Rocco, MD, PhD, FACS
- Professor and John and Mary Alford Chair of Head and Neck Surgery
- The Ohio State University Wexner Medical Center
- Section Editors
- Bruce E Brockstein, MD
Bruce E Brockstein, MD
- Section Editor — Cancer of the Head and Neck
- Clinical Professor of Medicine
- University of Chicago Pritzker School of Medicine
- David M Brizel, MD
David M Brizel, MD
- Section Editor — Radiation Therapy
- Leonard R Prosnitz Professor of Radiation Oncology
- Professor of Otolaryngology Head & Neck Surgery
- Duke University Cancer Institute
- Marshall R Posner, MD
Marshall R Posner, MD
- Section Editor — Cancer of the Head and Neck
- Professor of Gene and Cell Medicine
- The Tisch Cancer Institute
- Icahn School of Medicine at Mount Sinai
- Marvin P Fried, MD, FACS
Marvin P Fried, MD, FACS
- Section Editor — Head and Neck Surgery
- Professor and University Chairman, Department of Otorhinolaryngology - Head and Neck Surgery
- Montefiore Medical Center, Albert Einstein College of Medicine
The hypopharynx lies posterior and inferior to the oropharynx and extends to the esophageal inlet. Over 95 percent of hypopharyngeal cancers are squamous cell carcinomas. Other less common histologies include basaloid squamous carcinomas, spindle cell carcinomas, and minor salivary gland carcinomas.
At diagnosis, less than 15 percent of hypopharyngeal cancers are confined to the hypopharynx. Most have spread to the regional lymph nodes (65 percent) or distantly (20 percent). Presenting symptoms can include dysphagia, odynophagia, otalgia, hoarseness, dyspnea/stridor, and/or a painless neck mass. Diagnosis at an early-stage is uncommon due to a lack of alarming symptoms until local progression or neck metastasis is present. Countries that have introduced national diagnostic screening programs for early gastrointestinal (GI) malignancies are more likely to detect hypopharyngeal malignancy at an earlier stage.
The treatment of early hypopharyngeal cancers is presented here. The treatment of locally advanced hypopharyngeal cancer is discussed separately, as is the management of metastatic disease.
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