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HYPOPHARYNGEALCARCINOMA

HYPOPHARYNGEALCARCINOMA. Renji Hospital Pro Wang. HYPOPHARYNGEALCARCINOMA. • Work-up procedure • TNM staging • Primary treatment • Follow-up • Treatment of recurrent and/or metastatic disease. CLINICAL EVALUATION. complete history of the disease weight and weight loss

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HYPOPHARYNGEALCARCINOMA

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  1. HYPOPHARYNGEALCARCINOMA Renji Hospital Pro Wang

  2. HYPOPHARYNGEALCARCINOMA • • Work-up procedure • • TNM staging • • Primary treatment • • Follow-up • • Treatment of recurrent and/or metastatic disease

  3. CLINICAL EVALUATION • complete history of the disease • weight and weight loss • performance status (Karnofsky / ECOG-WHO) • fiberoptic examination of H&N mucosa • neck examination • drawing of any lesions

  4. ENDOSCOPIC EVALUATION • endoscopy under general anesthesia with biopsies of any suspicious site

  5. ADVANCED CLINICAL EVALUATION • dental examination by oral surgeon • nutritional assessment • others (if required)

  6. LABORATORY TESTS • hemogram, coagulation tests, liver enzymes, • kidney function • thyroid function: TSH

  7. IMAGING • Loco-regional: CT scan (or MRI) • Metastatic work-up: chest X-ray, thoracic spiral • CT scan • Additional examination depending on previous • findings • PET scan

  8. PATHOLOGIC EXAMINATION • Standards of the British Royal College of Pathologists

  9. HYPOPHARYNGEALCARCINOMA • • Work-up procedure • • TNM staging • • Primary treatment • • Follow-up • • Treatment of recurrent and/or metastatic disease

  10. TNM/AJCC 1997 STAGING • • T0: no evidence of primary tumor • • T1: Tumor limited to one subsite of hypopharynx and < 2 cm • • T2: Tumor invades more than one subsites of hypopharynx or an adjacent site, or > 2cm and < 4 cm without fixation of hemilarynx • • T3: > 4 cm or with fixation of hemilarynx • • T4a invades thyroid/cricoid cartilage, hyoid bone, thyroid gland, esophagus or central compartment soft tissue • • T4b invades prevertebral fascia, encases carotid artery, or invades mediastinal structures

  11. TNM/AJCC 1997 STAGING • • N0: no regional node metastasis • • Nx: regional nodes cannot be assessed • • N1: single ipsilateral node, <3 cm • • N2a: single ipsilateral node, > 3 cm and < 6 cm • • N2b: multiple ipsilateral nodes, <6 cm • • N2c: controlateral or bilateral nodes, <6 cm • • N3: node > 6 cm

  12. TNM/AJCC 1997 STAGING • • Mx: Distant metastasis cannot be assessed • • M0: No distant metastasis • • M1: Distant metastasis

  13. HYPOPHARYNGEALCARCINOMA • • Work-up procedure • • TNM staging • • Primary treatment • • Follow-up • • Treatment of recurrent and/or metastatic disease

  14. TREATMENT OF PYRIFORM SINUS TUMORS

  15. TREATMENT OF HYPOPHARYNGEAL TUMORS

  16. HYPOPHARYNGEALCARCINOMA • • Work-up procedure • • TNM staging • • Primary treatment • • Follow-up • • Treatment of recurrent and/or metastatic disease

  17. Clinical examination • fiberoptic examination and neck palpation every 2 months (first 2 years),every 6 months(3rd-5th year), then every year (> 5 years) • dental examination every 6 months

  18. Imaging-chest X-ray every year • Laboratory tests-thyroid function (TSH) every year • Evolution of late toxicity (EORTC/RTOG) scale

  19. HYPOPHARYNGEALCARCINOMA • • Work-up procedure • • TNM staging • • Primary treatment • • Follow-up • • Treatment of recurrent and/or metastatic disease

  20. SALVAGE TREATMENT FOR RECURRENT DISEASE: GENERAL PRINCIPLE Treatment will depend on: • Site and extension (rTNM stage) • Previous treatment(s) • Performance status • Patient wishes

  21. THANK YOU !

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