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
