Dieser Beitrag ist als Teil II der bereits in der LRO erschienenen Arbeit „Chirurgische Therapie des Oropharynxkarzinoms: Empfehlungen der aktuellen S3-Leitlinie – Teil I“ zu verstehen. Neben der chirurgischen Therapie des Primärtumors des Hypopharynxkarzinoms werden die Neck Dissection und die adjuvante postoperative Therapie des Oro- und Hypopharynxkarzinoms gemäß den Ausführungen der neuen S3-Leitlinie „Diagnostik, Therapie, Prävention und Nachsorge des Oro- und Hypopharynxkarzinoms“ [1 ] dargestellt.
Abstract
Part II of the S3 guideline report deals with the surgical treatment of hypopharyngeal carcinoma, neck dissection for oropharyngeal and hypopharyngeal carcinomas and adjuvant therapy options. Primary surgical therapy ± adjuvant radio- or radiochemotherapy and primary radio- or radiochemotherapy are established as primary therapies for local-regional hypopharyngeal carcinomas. Direct randomized comparisons of both basic therapeutic procedures were never conducted. Available registry data show a worse prognosis of hypopharyngeal carcinoma compared to oropharyngeal carcinomas in all locoregional tumor stages, regardless of the treatment method. For T1N0–T2N0 squamous cell carcinoma of the hypopharynx, there are no relevant differences in overall survival and locoregional relapse rate between primary surgical and primary non-surgical treatment. Primary surgical therapy ± adjuvant radiotherapy or radiochemotherapy and primary radiotherapy or radiochemotherapy are established as primary therapies for advanced but locoregionally limited hypopharyngeal carcinomas. Neck dissection is an integral part of the primary surgical treatment of oropharyngeal and hypopharyngeal cancer. There are only a few randomized studies on non-surgical organ preservation for advanced hypopharyngeal cancer as an alternative to pharyngolaryngectomy, but these have led to the recommendation of alternative concepts in the new guideline. The indication and implementation of postoperative adjuvant radiotherapy and radiochemotherapy for hypopharyngeal carcinoma do not differ from those for HPV/p16-negative and -positive oropharyngeal carcinoma.
Schlüsselwörter Hypopharynxkarzinom - Oropharynxkarzinom - Kopf-Hals-Tumoren - adjuvante Therapie - Neck Dissection - Chirurgie
Keywords hypopharyngeal carcinoma - oropharyngeal carcinoma - head and neck tumors - adjuvant therapy - neck dissection - surgical treatment
