A comparison of surgery and radiotherapy in the management of post-cricoid carcinoma

One hundred and forty-three patients with post-cricoid squamous cell carcinoma are described. Twenty-nine patients (20%) underwent pharyngolaryngoesophagectomy with gastric transposition. Forty-four patients (31%) were treated with radical radiotherapy and 70 (49%) had palliative therapy. Kaplan Meier 5-year survival following surgery was 45% and radiotherapy was 23%. The presence of nodal disease at presentation was the most significant prognostic factor. The 5-year survival of patients undergoing surgery with no palpable lymph node spread at presentation was 63% which compared with 25% following radiotherapy. This difference was statistically significant (P=0.0153: Logrank test stratified by nodal status). Patients with palpable metastatic nodal spread at presentation had 5-year survivals of 10% and 0% in the surgical and radiotherapy groups respectively. This study demonstrates that patients with post-cricoid carcinoma who present without palpable lymph node spread have a significant improved 5-year survival following surgery when compared with radiotherapy.