Voice preservation in treatment of carcinoma of the pyriform sinus.

A retrospective analysis of 175 patients having a histopathologic diagnosis of epidermoid carcinoma of the pyriform sinus presenting between January 1, 1964 and December 31, 1973 was undertaken to establish the effectiveness of conservation surgery in preserving voice. Patients were treated by three separate methods: 1. preoperative radiation therapy, partial laryngopharyngectomy and radical neck dissection (PLP and RND) (N = 85); 2. preoperative radiation therapy, total laryngopharyngectomy and radical neck dissection (TLP and RND), (N = 57); and 3. palliation, which consisted of palliative radiation therapy alone or combinations of radiation therapy and chemotherapy or palliative surgery (N = 33). Of the 85 patients treated with the expectation of cancer cure and voice preservation (PLP and RND), 44 or 52% actually had their voice preserved. Of course, in none of the patients treated by TLP and RND was voice preserved, but 2 of the 33 patients treated palliatively retained ability to speak. Overall, 46 of 175 patients (26%) with carcinoma of the pyriform sinus were afforded voice preservation. The ability to preserve voice is correlated with stage and an analysis of operative complications is presented.