The purpose of this review of the literature was to present treatment options for early stage pyriform sinus
cancer.
Squamous cell carcinoma of the pyriform sinus, as the most frequent
cancer arising from the hypopharynx, is rarely diagnosed in its early stage. Based on evidence from retrospective studies, conservation surgery and definitive
radiotherapy are considered the available treatment modalities for patients presenting with stage T1 and T2 pyriform sinus
carcinomas without clinical evidence of neck
lymph node metastases, offering similar results with respect to disease control and functional organ preservation. Also, the high risk of occult metastatic nodal disease even in the earliest stage of pyriform sinus
cancer entails elective
neck dissection or elective neck irradiation to be considered mandatory. However, for patients with early stage pyriform sinus
cancer, no level 1 study exists in which conservation surgery is compared with
radiotherapy alone for the evaluation of local control or survival. Randomized multicenter controlled trials evaluating efficacy of conservation surgery and definitive
radiotherapy, and correctly interpreting functional outcome for each of the treatment procedures examined are necessary to obtain sufficient evidence to influence the decision in the choice of the most effective treatment for early pyriform sinus
cancer.