Report of Head and Neck Cancer Registry of Japan. Clinical Statistics of Registered Patients, 2002

Transcription

1 Report of Head and Neck Cancer Registry of Japan Clinical Statistics of Registered Patients, Japan Society for Head and Neck Cancer Cancer Registry Committee

2 Preface The Head and Neck Cancer Registry of Japan was founded in 98 by the Subcommittee for Head and Neck Cancer of the Japanese Joint Committee. Although its first purpose was to formulate Japanese proposals for the TNM classification based on collected data, it soon became apparent that this vast registry contributes greatly to the understanding of the statistics and treatments of head and neck cancer in Japan. One thousand one hundred and seventy-six patients treated in 979 were registered in the first registration which took place in 98. Since then the registration has been repeated every year. Although the annual number of registered patients had increased steadily until 99, it shifted to a constant decline afterwards because this registry was not supported by any societies and therefore its data were not totally public and were available only to researchers in the cooperating institutions. In, the Japan Society for Head and Neck Cancer decided to support the Head and Neck Cancer Registry to maintain the quality of its data and created the Cancer Registry Committee to renew the old-fashioned registration system. The first new registration took place in 3, registering,335 head and neck cancer patients treated in. This supplement is the report of the second year of the new registration. I would like to express my deepest appreciation to the Japan Society for Head and Neck Cancer for the academic and financial support. I would also like to thank Ms. Kazumi Oono for her help in the management of registration forms. Last but not least, I would like to express my gratitude to all the doctors in the participating institutions, hopefully expecting their successive cooperation. I hope this English edition will provide valuable information in the field of head and neck oncology not only nationally but internationally. August 9, 6 Masahisa Saikawa, MD Chairperson Cancer Registry Committee, Japan Society for Head and Neck Cancer This work was supported by the Japan Society for Head and Neck Cancer and a Grant-in-Aid for Cancer Research from the Ministry of Health, Labour and Welfare, Japan. i

3 Cancer Registry Committee, Japan Society for Head and Neck Cancer Chairperson Members Masahisa Saikawa Hideki Chijiwa, Takashi Fujii, Hiroyuki Harada, Seiichi Yoshimoto, and Takashi Yoshizumi Secretariat Division of Head and Neck Surgery, National Cancer Center Hospital East 6-5- Kashiwanoha, Kashiwa, Chiba, Japan Phone: ext (Aug. 6) Data Collection All the member institutions of the Japan Society for Head and Neck Cancer were advised to participate in the registration. The secretariat sent registration forms to 54 institutions which expressed their cooperation. The completed registration forms provide information regarding patients age and sex, tumor pathology, TNM classifications, site and size of the primary tumor and neck metastases, therapies (surgery, radiation, and chemotherapy), and prognosis. All registration forms returned by 45 institutions were thoroughly reviewed by head and neck oncologists, stored in a computerized data file, and analyzed in the secretariat. Registration was restricted to previously untreated cancer cases which had pathological confirmation and arose in the aero-digestive tract of the head and neck area, i.e. the oral cavity, larynx, hypopharynx, oropharynx, nasopharynx, nasal cavity or paranasal sinuses. Tumors arising in the cervical esophagus were excluded. Head and neck tumors were classified according to the General Rules for Clinical Studies on Head and Neck Cancer (The Third Edition, November, Japan Society for Head and Neck Cancer), which are based on the TNM Classification of Malignant Tumours (Fifth Edition, 997) of the International Union Against Cancer (UICC). For head and neck cancer patients treated in,,6 completed registration forms were returned to the secretariat, of which 6 were excluded (double registration 36, pre-treatment unknown, primary site unknown 7, treated cases 6, primary site not meeting the registration criteria, pathology unknown ), making the total number of registered patients,64. A follow-up study of these patients is scheduled for 8, in which each case will have a follow-up period of more than 5 years. ii

4 List of 45 Institutions which participated in the Registry in. Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine. Division of Oral & Maxillofacial Surgery, Department of Oral Pathobiological Science, Graduate School of Dental Medicine, Hokkaido University 3. Division of Maxillofacial Surgery, Tohoku University Graduate School of Dentistry 4. Division of Head and Neck Surgery, Miyagi Cancer Center Hospital 5. Division of Otorhinolaryngology & Head and Neck Surgery, Department of Sensory Medicine, Akita University School of Medicine 6. Department of Dentistry and Oral Surgery, Okubo Hospital 7. Department of Otolaryngology-Head and Neck Surgery, Jichi Medical School 8. Department of Head and Neck, Gunma Cancer Center 9. Department of Otorhinolaryngology, National Defense Medical College. Department of Head and Neck Surgery, Saitama Cancer Center. Division of Otorhinolaryngology, Graduate School of Medicine, Chiba University. Division of Head and Neck Surgery, Chiba Cancer Center Hospital 3. Head and Neck Surgery Division, National Cancer Center Hospital 4. Department of Otolaryngology, Nippon Medical School 5. Department of Otorhinolaryngology-Head and Neck Surgery, Graduate School of Medicine, University of Tokyo 6. Maxillofacial Surgery, Department of Maxillofacial Reconstruction and Function, Division of Maxillofacial and Neck Reconstruction, Graduate School, Tokyo Medical and Dental University 7. Oral and Maxillofacial Surgery, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University 8. Department of Otorhinolaryngology, School of Medicine, Keio University 9. Department of Otorhinolaryngology, Tokyo Medical University. Department of Otolaryngology, Tokyo Women s Medical University. Department of Radiology, Tokyo Women s Medical University. Department of Otolaryngology, Head and Neck Surgery, Kyorin University School of Medicine 3 Division of Head and Neck, Cancer Institute Hospital, Tokyo 4. Department of Oral and Maxillofacial Surgery, Yokohama City University 5. Department of Otorhinolaryngology, Showa University Northern Yokohama Hospital iii

5 6. Department of Otorhinolaryngology Head and Neck Surgery, University of Fukui Faculty of Medical Sciences 7. Department of Otolaryngology and Department of Oral Surgery, Yamanashi Prefectural Central Hospital 8. Department of Dental and Oral Surgery, Shinshu University School of Medicine 9. Department of Head and Neck Surgery, Aichi Cancer Center 3. Department of Otorhinolaryngology, Kyoto Second Red Cross Hospital 3. Department of Otolaryngology, Head and Neck Surgery, Kansai Medical University 3. Second Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry 33. Department of Otolaryngology, Osaka Medical Center for Cancer and Cardiovascular Diseases 34. Division of Otolaryngology-Head and Neck Surgery, Osaka General Medical Center 35. Department of Otorhinolaryngology, Osaka Koseinenkin Hospital 36. Department of Head and Neck Surgery, Hyogo Medical Center for Adults 37. Department of Otorhinolaryngology, Yoka Hospital 38. Department of Otolaryngology-Head and Neck Surgery, Wakayama Medical University 39. Oral and Maxillofacial Surgery, Division of Medico-Dental Dynamics and Reconstruction, Subdivision of Medical Science for Oral and Maxillofacial Regeneration, The University of Tokushima School of Dentistry 4. Department of Otorhinolaryngology, Faculty of Medicine, Kagawa University 4. Division of Head and Neck Surgery, Shikoku Cancer Center 4. Department of Otolaryngology-Head and Neck Surgery, Kurume University, School of Medicine 43. Department of Otolaryngology-Head and Neck Surgery (Unit of Translational Medicine), Nagasaki University Graduate School of Biomedical Sciences 44. Department of Otolaryngology, Oita University Faculty of Medicine 45 Department of Otorhinolaryngology, Kagoshima City Hospital iv

6 Contents List of 45 Institutions which participated in the Registry in iii Cases Oral Cavity Larynx Hypopharynx Oropharynx Nasopharynx Nasal Cavity and Paranasal Sinuses Excluding the Maxillary Sinus Maxillary Sinus v

7 Cases () 64 Cases

8 Head and Neck Carcinoma Cases Primary Site Site ) Oral cavity ) Larynx 3) Hypopharynx 4) Oropharynx 5) Nasopharynx 6) Nasal cavity, etc. 7) Maxillary sinus Number of patients ( 3.8%) ( 3.8%) ( 8.%) ( 3.4%) 88 ( 4.%) 56 (.6%) 39 ( 6.4%) 64 (.%) Nasal cavity, etc. : nasal cavity and paranasal sinuses (excluding the maxillary sinus). Age Distribution by Gender Age Unknown Male Female Unknown

9 3 Head and Neck Carcinoma Cases Histological Distribution by Primary Site () () (3) (4) Nasal cavity, etc. : nasal cavity and paranasal sinuses (excluding the maxillary sinus). Malig., malig.: malignant. Ca., ca.: carcinoma. undiff.: undifferentiated. S.C.C.: squamous cell carcinoma. kerat.: keratinizing. nonkerat.: nonkeratinizing. quest.: questionable. inv.: invasion. (5) (6) Nasal cavity, (7) Histologic type Oral Hypopharynpharynpharynx Oro- Naso- Larynx cavity etc. sinus Neoplasm, malig. 3 Carcinoma, NOS Ca., undiff., NOS Verrucous ca., NOS 4 Papillary S.C.C. 6 S.C.C. in situ, NOS S.C.C., NOS S.C.C., kerat., NOS S.C.C., large cell, nonkerat. S.C.C., small cell, nonkerat. S.C.C., spindle cell 5 S.C.C. in situ with quest. stromal inv. Basal cell ca., NOS Transitional cell ca., NOS Adenocarcinoma, NOS Adenoid cystic ca. 8 Carcinoid tumor, NOS Mucoepidermoid ca. 7 Acinar cell ca. Adenosquamous ca. 3 4 Malig. melanoma, NOS Giant cell sarcoma Fibrous histiocytoma, malig. Rhabdomyosarcoma, NOS Mixed tumor, malig., NOS Carcinosarcoma, NOS Osteosarcoma, NOS Chondrosarcoma, NOS Esthesioneuroblastoma 6 6 Malig. lymphoma, NOS 3 6 Plasmacytoma, NOS Maxillary

10 4 Head and Neck Carcinoma Cases Histological Distribution by Primary Site (Male) () () (3) (4) Nasal cavity, etc. : nasal cavity and paranasal sinuses (excluding the maxillary sinus). Malig., malig.: malignant. Ca., ca.: carcinoma. undiff.: undifferentiated. S.C.C.: squamous cell carcinoma. kerat.: keratinizing. nonkerat.: nonkeratinizing. quest.: questionable. inv.: invasion. (5) (6) Nasal cavity, (7) Histologic type Oral Hypopharynpharynpharynx Oro- Naso- Larynx cavity etc. sinus Neoplasm, malig. 8 Carcinoma, NOS 4 Ca., undiff., NOS Verrucous ca., NOS 6 7 Papillary S.C.C. 5 S.C.C. in situ, NOS S.C.C., NOS S.C.C., kerat., NOS S.C.C., large cell, nonkerat. S.C.C., small cell, nonkerat. S.C.C., spindle cell 4 S.C.C. in situ with quest. stromal inv. Basal cell ca., NOS Transitional cell ca., NOS Adenocarcinoma, NOS Adenoid cystic ca Carcinoid tumor, NOS Mucoepidermoid ca. 4 Acinar cell ca. Adenosquamous ca. 3 3 Malig. melanoma, NOS 3 4 Giant cell sarcoma Fibrous histiocytoma, malig. Rhabdomyosarcoma, NOS Mixed tumor, malig., NOS Carcinosarcoma, NOS Osteosarcoma, NOS Chondrosarcoma, NOS Esthesioneuroblastoma 4 4 Malig. lymphoma, NOS 3 Plasmacytoma, NOS Maxillary

11 5 Head and Neck Carcinoma Cases Histological Distribution by Primary Site (Female) () () (3) (4) (5) (6) (7) Nasal cavity, Histologic type Oral Hypopharynpharynpharynx Oro- Naso- Larynx cavity etc. sinus Neoplasm, malig. Carcinoma, NOS 4 Ca., undiff., NOS 6 Verrucous ca., NOS 6 7 Papillary S.C.C. S.C.C. in situ, NOS 3 6 S.C.C., NOS S.C.C., kerat., NOS S.C.C., large cell, nonkerat. S.C.C., small cell, nonkerat. S.C.C., spindle cell S.C.C. in situ with quest. stromal inv. Basal cell ca., NOS Transitional cell ca., NOS Adenocarcinoma, NOS 3 7 Adenoid cystic ca. 4 4 Carcinoid tumor, NOS Mucoepidermoid ca. 5 7 Acinar cell ca. Adenosquamous ca. Malig. melanoma, NOS 5 8 Giant cell sarcoma Fibrous histiocytoma, malig. Rhabdomyosarcoma, NOS Mixed tumor, malig., NOS Carcinosarcoma, NOS Osteosarcoma, NOS Chondrosarcoma, NOS Esthesioneuroblastoma Malig. lymphoma, NOS 3 Plasmacytoma, NOS Maxillary Nasal cavity, etc. : nasal cavity and paranasal sinuses (excluding the maxillary sinus). Malig., malig.: malignant. Ca., ca.: carcinoma. undiff.: undifferentiated. S.C.C.: squamous cell carcinoma. kerat.: keratinizing. nonkerat.: nonkeratinizing. quest.: questionable. inv.: invasion.

12 6 Head and Neck Carcinoma Cases T and N Status N N N Na Nb Nc N3 NX N- T Tis T T T T4 TX T T-: T classification not defined. N-: N classification not defined. T and N Status (M Cases) N N N Na Nb Nc N3 NX N- T Tis 3 3 T T T T TX 7 3 T T-: T classification not defined. N-: N classification not defined.

13 7 Head and Neck Carcinoma Cases T and N Status (M Cases) N N N Na Nb Nc N3 NX N- T Tis T T T3 T4 TX T T-: T classification not defined. N-: N classification not defined. T and N Status (MX Cases) N N N Na Nb Nc N3 NX N- T Tis T 6 7 T T T TX 4 T T-: T classification not defined. N-: N classification not defined.

14 8 Head and Neck Carcinoma Cases Treatment Method for the Primary Lesion by Primary Site () () (3) (4) (5) (6) (7) Treatment method Oral cavity Larynx Hypopharynx Oropharynx Nasopharynx Nasal cavity, etc. Maxillary sinus Surgery ) Without ) With ) Unknown Radiotherapy ) Without ) With ) Unknown 3 6 Chemotherapy ) Without ) With ) Unknown Nasal cavity, etc. : nasal cavity and paranasal sinuses (excluding the maxillary sinus). Treatment Method for the Cervical Lymph Nodes by Primary Site () () (3) (4) (5) (6) (7) Treatment method Oral cavity Larynx Hypopharynx Oropharynx Nasopharynx Nasal cavity, etc. Maxillary sinus Surgery ) Without ) With ) Unknown 5 3 Radiotherapy ) Without ) With ) Unknown Chemotherapy ) Without ) With ) Unknown Nasal cavity, etc. : nasal cavity and paranasal sinuses (excluding the maxillary sinus).

15 9 Head and Neck Carcinoma Cases Sequence of Treatment Methods for the Primary Lesion by Primary Site Sequence of treatment methods () () (3) (4) (5) (6) Oral cavity Larynx Hypopharynx Oropharynx Nasopharynx etc. No treatment A) Surg. alone B) Rad. alone F) (Rad.+Chem.) AB) Surg.->Rad FA) (Rad.+Chem.)->Surg BA) Rad.->Surg CB) Chem.->Rad CA) Chem.->Surg CAB) Chem.->Surg.->Rad C) Chem. alone ABC) Surg.->Rad.->Chem BC) Rad.->Chem AC) Surg.->Chem AF) Surg.->(Rad.+Chem.) FC) (Rad.+Chem.)->Chem CF) Chem.->(Rad.+Chem.) FAB) (Rad.+Chem.)->Surg.->Rad BAC) Rad.->Surg.->Chem CAC) Chem.->Surg.->Chem. 6 3 CBA) Chem.->Rad.->Surg. 5 Others Unknown Nasal cavity, etc. : nasal cavity and paranasal sinuses (excluding the maxillary sinus). Surg.: surgery. Rad.: radiotherapy. Chem.: chemotherapy. Treatment methods in parentheses were given concurrently. Nasal cavity, (7) Maxillary sinus

16 Surgical method Head and Neck Carcinoma Cases Surgical Method for the Primary Lesion by Primary Site () () (3) (4) Oral cavity Larynx etc. H) No surgery A) Partial glossectomy C4) laryngectomy 79 8 E) Partial maxillectomy DC4H6) Pharyngolaryngoesophagectomy A) Hemiglossectomy 5 5 E3) maxillectomy 36 4 C9) Laryngectomy, other type 3 3 DC4) pharyngolaryngectomy 9 9 D) Partial hypopharyngectomy 5 7 C) Partial laryngectomy 4 4 A3) Subtotal glossectomy 3 3 C4G) laryngectomy 3 with thyroid lobectomy H) Resection of the floor of mouth H4) Resection of the buccal mucosa B3) Unilateral resection of the 9 9 lateral of the oropharynx D) hypopharyngectomy 7 7 DC4G) pharyngolaryngectomy with thyroid lobectomy 7 7 H9)+ Others Unknown Nasal cavity, etc. : nasal cavity and paranasal sinuses (excluding the maxillary sinus). (5) Hypopharynx Oropharynx Nasopharynx (6) Nasal cavity, (7) Maxillary sinus

17 Head and Neck Carcinoma Cases Neck Dissection on the Ipsilateral Side by Primary Site () () (3) (4) (5) (6) (7) Neck dissection Oral cavity Larynx Hypopharynx Oropharynx Nasopharynx Nasal cavity, etc. Maxillary sinus ) No N.D ) Radical N.D ) Conservative N.D. 3) Upper N.D ) Partial N.D ) Enucleation ) Others 3 4 9) Unknown Nasal cavity, etc. : nasal cavity and paranasal sinuses (excluding the maxillary sinus). N.D.: neck dissection. Neck Dissection on the Contralateral Side by Primary Site Neck dissection () () (3) (4) (5) (6) (7) Oral cavity Larynx Nasal cavity, etc. Hypopharynx Oropharynx Nasopharynx Maxillary sinus ) No N.D ) Radical N.D ) Conservative N.D. 3) Upper N.D ) Partial N.D ) Enucleation 5 8) Others 3 5 9) Unknown Nasal cavity, etc. : nasal cavity and paranasal sinuses (excluding the maxillary sinus). N.D.: neck dissection.

18 Reconstructive surgery Head and Neck Carcinoma Cases Reconstructive Surgery by Primary Site () () (3) (4) (5) (6) (7) Oral cavity Larynx Nasopharynx Hypopharynx Oropharynx Nasal cavity, etc. ) No reconstruction B) Free jejunal flap D) Free RA MC flap C) Free FA flap ) Skin graft ) PM MC flap ) Local skin flap 5 E) Free anterolateral thigh flap 4 7 C) Free FA flap + skin graft 7 9 3) Mucosal flap 3 7 4) DP flap F) Free scapular OC flap 6 G) Free fibular OC flap 6 6 7) Gastric pullup 4 5 D8) Free RA MC flap + others 4 5 8)+ Others ) Unknown Nasal cavity, etc. : nasal cavity and paranasal sinuses (excluding the maxillary sinus). RA: rectus abdominis. MC: musculocutaneous. FA: forearm. PM: pectoralis major. DP: deltopectoral. OC: osteocutaneous. Maxillary sinus

19 3 Type of radiotherapy Head and Neck Carcinoma Cases () () (3) (4) Oral cavity Radiotherapy by Primary Site Larynx (6) Nasal cavity, etc. Maxillary sinus ) No radiotherapy ) X-ray ) Electron beam ) 6 Co γ-ray ) X-ray + electron beam D) LDR B.T. with 98 Au 8 8 B) LDR B.T. with 37 Cs 7 7 ) 6 Co γ-ray + X-ray 4 6) HDR B.T. with 9 Ir 3 B) LDR B.T. with 37 Cs + X-ray 3 3 6) X-ray + HDR B.T. with 9 Ir D) X-ray + LDR B.T. with 98 Au 7) HDR B.T. with 6 Co A) LDR B.T. with 9 Ir A) LDR B.T. with 9 Ir + 6 Co γ-ray D) LDR B.T. with 98 Au + X-ray 8)+ Others 5 9 9) Unknown Nasal cavity, etc. : nasal cavity and paranasal sinuses (excluding the maxillary sinus). LDR: low dose rate. B.T.: brachytherapy. HDR: high dose rate. (5) Hypopharynx Oropharynx Nasopharynx (7)

20 4 Route of Administration () () (3) (4) (5) (6) (7) Oral cavity Head and Neck Carcinoma Cases Chemotherapy by Primary Site Larynx Nasopharynx Hypopharynx Oropharynx ) No chemotherapy ) Intravenous ) Intraarterial ) Oral ) Others 4 4 9) Unknown Nasal cavity, etc. : nasal cavity and paranasal sinuses (excluding the maxillary sinus). Nasal cavity, etc. Maxillary sinus

21 5 Oral Cavity () 688 Cases

22 6 Carcinoma of the Oral Cavity Cases Subsite Subsite ) Lip ) Buccal mucosa 3) Retromolar area 4) Lower gingiva 5) Upper gingiva 6) Hard palate 7) Floor of mouth 8) Tongue 9) Oral cavity, NOS Number of patients (.5%) 49 ( 7.%) 4 (.%) 79 (.5%) 4 ( 6.%) ( 3.%) 66 ( 9.6%) 47 ( 59.%) (.%) 688 (.%)

23 7 Carcinoma of the Oral Cavity Cases Age Distribution by Gender Age Unknown Male Female Unknown Carcinoma of the Lip Age Distribution by Gender Age Unknown Male Female Unknown 6

24 8 Carcinoma of the Oral Cavity Cases Carcinoma of the Buccal Mucosa Age Distribution by Gender Age Unknown Male Female Unknown Carcinoma of the Retromolar Area Age Distribution by Gender Age Unknown Male Female Unknown 4 8 4

25 9 Carcinoma of the Oral Cavity Cases Carcinoma of the Lower Gingiva Age Distribution by Gender Age Unknown Male Female Unknown Carcinoma of the Upper Gingiva Age Distribution by Gender Age Unknown Male 6 Female Unknown

26 Carcinoma of the Oral Cavity Cases Carcinoma of the Hard Palate Age Distribution by Gender Age Unknown Male Female Unknown Carcinoma of the Floor of Mouth Age Distribution by Gender Age Unknown Male Female Unknown

27 Carcinoma of the Oral Cavity Cases Carcinoma of the Tongue Age Distribution by Gender Age Unknown Male Female Unknown Carcinoma of the Oral Cavity, NOS Age Distribution by Gender Age Unknown Male Female Unknown

28 Histologic type Carcinoma of the Oral Cavity Cases Histological Distribution by Subsite () () (3) (4) Retromolar Lip Buccal mucosa Lower gingiva area mouth NOS Neoplasm, malig. 3 Carcinoma, NOS Ca., undiff., NOS Verrucous ca., NOS 4 6 Papillary S.C.C. S.C.C. in situ, NOS 5 6 S.C.C., NOS S.C.C., kerat., NOS S.C.C., large cell, nonkerat. S.C.C., small cell, nonkerat. S.C.C., spindle cell S.C.C. in situ with quest. stromal inv. Basal cell ca., NOS Adenocarcinoma, NOS 3 Adenoid cystic ca. 3 Mucoepidermoid ca Acinar cell ca. Adenosquamous ca. Malig. melanoma, NOS 4 Fibrous histiocytoma, malig. Osteosarcoma, NOS Malig. lymphoma, NOS Malig., malig.: malignant. Ca., ca.: carcinoma. undiff.: undifferentiated. S.C.C.: squamous cell carcinoma. kerat.: keratinizing. nonkerat.: nonkeratinizing. quest.: questionable. inv.: invasion. (5) Upper gingiva (6) Hard palate (7) (8) Floor of Tongue (9) Oral cavity,

29 3 Carcinoma of the Oral Cavity Cases T and N Status N N N Na Nb Nc N3 NX N- T Tis T T 4 * T3 49 * 33 8 T4 33 * * 5 * * TX T M: 6 cases. Each * signifies one M case. T-: T classification not defined. N-: N classification not defined. Carcinoma of the Lip T and N Status N N N Na Nb Nc N3 NX N- T Tis T 4 6 T 3 T3 T4 TX T- 6 3 M: case. T-: T classification not defined. N-: N classification not defined.

30 4 Carcinoma of the Oral Cavity Cases Carcinoma of the Buccal Mucosa T and N Status N N N Na Nb Nc N3 NX N- T Tis T 3 T 7 3 T3 4 6 T4 3 * 3 8 TX T M: case. Each * signifies one M case. T-: T classification not defined. N-: N classification not defined. Carcinoma of the Retromolar Area T and N Status N N N Na Nb Nc N3 NX N- T Tis T 3 3 T 4 6 T3 T4 4 TX T M: case. T-: T classification not defined. N-: N classification not defined.

31 5 Carcinoma of the Oral Cavity Cases Carcinoma of the Lower Gingiva T and N Status N N N Na Nb Nc N3 NX N- T Tis T 3 4 T * T3 3 5 T TX T M: case. Each * signifies one M case. T-: T classification not defined. N-: N classification not defined. Carcinoma of the Upper Gingiva T and N Status N N N Na Nb Nc N3 NX N- T Tis T T T3 8 T4 6 3 * TX T M: case. Each * signifies one M case. T-: T classification not defined. N-: N classification not defined.

32 6 Carcinoma of the Oral Cavity Cases Carcinoma of the Hard Palate T and N Status N N N Na Nb Nc N3 NX N- T Tis T T T3 3 T4 TX T- 6 M: case. T-: T classification not defined. N-: N classification not defined. Carcinoma of the Floor of Mouth T and N Status N N N Na Nb Nc N3 NX N- T Tis T 8 T T T4 3 4 TX T M: case. T-: T classification not defined. N-: N classification not defined.

33 7 Carcinoma of the Oral Cavity Cases Carcinoma of the Tongue T and N Status N N N Na Nb Nc N3 NX N- T Tis T T T3 3 6 * 7 75 T * * 33 TX T M: 3 cases. Each * signifies one M case. T-: T classification not defined. N-: N classification not defined. Carcinoma of the Oral Cavity, NOS T and N Status N N N Na Nb Nc N3 NX N- T Tis T T T3 T4 TX T- M: case. T-: T classification not defined. N-: N classification not defined.

34 8 Carcinoma of the Oral Cavity Cases Treatment Method for the Primary Lesion by Subsite () () (3) (4) (5) (6) (7) (8) (9) Treatment method Lip Buccal mucosa Retromolar area Lower gingiva Upper gingiva Hard palate Floor of mouth Tongue Oral cavity, NOS Surgery ) Without ) With ) Unknown Radiotherapy ) Without ) With ) Unknown 3 Chemotherapy ) Without ) With ) Unknown Treatment Method for the Cervical Lymph Nodes by Subsite () () (3) (4) (5) (6) (7) (8) (9) Treatment method Lip Buccal mucosa Retromolar area Lower gingiva Upper gingiva Hard palate Floor of mouth Tongue Oral cavity, NOS Surgery ) Without ) With ) Unknown 3 5 Radiotherapy ) Without ) With ) Unknown Chemotherapy ) Without ) With ) Unknown

35 9 Sequence of treatment methods Carcinoma of the Oral Cavity Cases Sequence of Treatment Methods for the Primary Lesion by Subsite () () (3) (4) (5) (6) Retromolar Lip Buccal mucosa Lower gingiva Upper gingiva Hard palate (7) (8) Floor of Tongue area mouth NOS No treatment 7 A) Surg. alone B) Rad. alone CA) Chem.->Surg FA) (Rad.+Chem.)->Surg BA) Rad.->Surg. 5 3 AB) Surg.->Rad F) (Rad.+Chem.) CB) Chem.->Rad. 9 CAB) Chem.->Surg.->Rad. 6 ABC) Surg.->Rad.->Chem. 5 9 AC) Surg.->Chem. 3 8 C) Chem. alone 7 7 E) (Surg.+Chem.) 3 7 CAC) Chem.->Surg.->Chem. 4 6 BAC) Rad.->Surg.->Chem. 4 BC) Rad.->Chem. 3 4 AF) Surg.->(Rad.+Chem.) 3 CBCB) Chem.->Rad.->Chem.->Rad. 3 3 FAB) (Rad.+Chem.)->Surg.->Rad. 3 Others Unknown Surg.: surgery. Rad.: radiotherapy. Chem.: chemotherapy. Treatment methods in parentheses were given concurrently. (9) Oral cavity,

36 3 Surgical method area mouth NOS H) No surgery A) Partial glossectomy 8 A) Hemiglossectomy 5 5 E) Partial maxillectomy A3) Subtotal glossectomy 3 3 H) Resection of the floor of mouth H4) Resection of the buccal mucosa F3) Segmental mandibulectomy 4 F) Marginal mandibulectomy 3 3 H) Resection of the lip 8 8 A3F) Subtotal glossectomy with 7 7 marginal mandibulectomy H3) Resection of the lower gingiva 7 7 HF) Resection of the floor of mouth 5 5 with marginal mandibulectomy H4F) Resection of the buccal mucosa 5 5 with marginal mandibulectomy H9)+ Others Unknown Carcinoma of the Oral Cavity Cases Surgical Method for the Primary Lesion by Subsite () () (3) (4) (5) (6) Lip Buccal mucosa Retromolar Lower gingiva Upper gingiva Hard palate (7) (8) Floor of Tongue (9) Oral cavity,

37 3 Carcinoma of the Oral Cavity Cases Neck Dissection on the Ipsilateral Side by Subsite () () (3) (4) (5) (6) (7) (8) (9) Neck dissection Lip Buccal mucosa ) No N.D ) Radical 3 3 N.D. ) Conservative N.D. 3) Upper N.D. 4) Partial 8 N.D. 5) Enucleation 8) Others 9) Unknown Retromolar area Lower gingiva Upper gingiva Hard palate Floor of mouth Tongue Oral cavity, NOS ) No N.D ) Radical N.D. ) Conservative N.D. 3) Upper N.D. 4) Partial 5 9 N.D. 5) Enucleation 5 8 8) Others 9) Unknown N.D.: neck dissection. Neck Dissection on the Contralateral Side by Subsite () () (3) (4) (5) (6) (7) (8) (9) Neck dissection Lip Buccal mucosa Retromolar area Lower gingiva Upper gingiva Hard palate Floor of mouth Tongue Oral cavity, NOS N.D.: neck dissection.

38 3 Reconstructive surgery Lip Carcinoma of the Oral Cavity Cases Reconstructive Surgery by Subsite () () (3) (4) (5) (6) Buccal mucosa Retromolar area Lower gingiva Upper gingiva Hard palate (7) (8) Floor of Tongue mouth ) No reconstruction C) Free FA flap D) Free RA MC flap ) Skin graft ) PM MC flap ) Local skin flap E) Free anterolateral thigh flap 3 7 C) Free FA flap + skin graft 3 7 G) Free fibular OC flap 6 6 3) Mucosal flap 3 4) DP flap 3 8)+ Others ) Unknown FA: forearm. RA: rectus abdominis. MC: musculocutaneous. PM: pectoralis major. OC: osteocutaneous. DP: deltopectoral. (9) Oral cavity, NOS

39 33 Type of radiotherapy Lip Carcinoma of the Oral Cavity Cases Radiotherapy by Subsite () () (3) (4) (5) (6) Buccal mucosa Retromolar area Lower gingiva Upper gingiva Hard palate (7) (8) Floor of Tongue mouth ) No radiotherapy ) X-ray ) Electron beam ) 6 Co γ-ray D) LDR B.T. with 98 Au 3 8 B) LDR B.T. with 37 Cs 5 7 3) X-ray + electron beam 6 B) LDR B.T. with 37 Cs + X-ray 3 3 D) X-ray + LDR B.T. with 98 Au 6) HDR B.T. with 9 Ir A) LDR B.T. with 9 Ir A) LDR B.T. with 9 Ir + 6 Co γ-ray D) LDR B.T. with 98 Au + X-ray 8)+ Others 6 9) Unknown LDR: low dose rate. B.T.: brachytherapy. HDR: high dose rate. (9) Oral cavity, NOS

40 34 Route of Administration ) No chemotherapy ) Intravenous ) Intraarterial ) Oral ) Others 4 9) Unknown Lip Carcinoma of the Oral Cavity Cases Buccal mucosa Chemotherapy by Subsite () () (3) (4) (5) Retromolar area Lower gingiva Upper gingiva (6) (7) (8) (9) Hard palate Floor of mouth Tongue Oral cavity, NOS

41 35 Larynx () 54 Cases

42 36 Carcinoma of the Larynx Cases Subsite Subsite Glottis Supraglottis Subglottis Larynx, NOS Number of patients 35 ( 68.3%) ( 6.5%) (.7%) (.5%) (.%) Age Distribution by Gender Age Unknown Male Female Unknown

43 37 Carcinoma of the Larynx Cases Glottic Carcinoma Age Distribution by Gender Age Unknown Male Female Unknown Supraglottic Carcinoma Age Distribution by Gender Age Unknown Male Female Unknown

44 38 Carcinoma of the Larynx Cases Subglottic Carcinoma Age Distribution by Gender Age Unknown Male Female Unknown Carcinoma of the Larynx, NOS Age Distribution by Gender Age Unknown Male 3 Female 3 Unknown

45 39 Carcinoma of the Larynx Cases Histologic type Neoplasm, malig. Verrucous ca., NOS Papillary S.C.C. S.C.C. in situ, NOS S.C.C., NOS S.C.C., kerat., NOS S.C.C., large cell, nonkerat. S.C.C., small cell, nonkerat. S.C.C., spindle cell S.C.C. in situ with quest. stromal inv. Adenoid cystic ca. Carcinoid tumor, NOS Mucoepidermoid ca. Adenosquamous ca. Giant cell sarcoma Histological Distribution by Subsite Glottis (C3.) Supraglottis (C3.) 9 36 Subglottis (C3.) 4 Larynx, NOS (C3.9) ca.: carcinoma. kerat.: keratinizing. quest.: questionable. malig.: malignant. S.C.C.: squamous cell carcinoma. nonkerat.: nonkeratinizing. inv.: invasion. T and N Status N N N Na Nb Nc N3 NX N- T Tis 3 3 T 6 T T T4 3 * TX 3 T M: case. Each * signifies one M case. T-: T classification not defined. N-: N classification not defined.

46 4 Carcinoma of the Larynx Cases Glottic Carcinoma T and N Status N N N Na Nb Nc N3 NX N- T Tis 3 3 T 7 7 Ta Tb T T T TX T M: case. T-: T classification not defined. N-: N classification not defined. Supraglottic Carcinoma T and N Status N N N Na Nb Nc N3 NX N- T Tis T 8 4 T T T TX T M: case. T-: T classification not defined. N-: N classification not defined.

47 4 Carcinoma of the Larynx Cases Subglottic Carcinoma T and N Status N N N Na Nb Nc N3 NX N- T Tis T T 3 4 T3 T4 5 * 7 TX T- 4 M: case. Each * signifies one M case. T-: T classification not defined. N-: N classification not defined. Carcinoma of the Larynx, NOS T and N Status N N N Na Nb Nc N3 NX N- T Tis T T 3 5 T3 4 5 T4 3 TX T M: case. T-: T classification not defined. N-: N classification not defined.

48 4 Treatment method Glottis Supraglottis Subglottis Larynx, NOS (C3.) (C3.) (C3.) (C3.9) Surgery ) Without ) With ) Unknown Radiotherapy ) Without ) With ) Unknown Chemotherapy ) Without ) With ) Unknown Carcinoma of the Larynx Cases Treatment Method for the Primary Lesion by Subsite Sequence of Treatment Methods for the Primary Lesion by Subsite Sequence of Glottis Supraglottis Subglottis Larynx, NOS treatment methods (C3.) (C3.) (C3.) (C3.9) No treatment 5 8 B) Rad. alone A) Surg. alone F) (Rad.+Chem.) AB) Surg.->Rad BA) Rad.->Surg FA) (Rad.+Chem.) >Surg. BC) Rad.->Chem. 5 6 CB) Chem.->Rad. 6 6 AF) Surg.-> (Rad.+Chem.) 3 5 CBA) Chem.->Rad. ->Surg. 3 5 C) Chem. alone 4 CA) Chem.->Surg. 3 FC) (Rad.+Chem.) 3 ->Chem. Others Unknown Rad.: radiotherapy. Surg.: surgery. Chem.: chemotherapy. Treatment methods in parentheses were given concurrently.

49 43 Treatment method T Tis T T T3 T4 TX T- Surgery ) Without ) With ) Unknown Radiotherapy ) Without ) With ) Unknown Chemotherapy ) Without ) With ) Unknown T-: T classification not defined. Carcinoma of the Larynx Cases Treatment Method for the Primary Lesion by T Classification Sequence of Treatment Methods for the Primary Lesion by T Classification Sequence of treatment methods T Tis T T T3 T4 TX T- No treatment 3 8 B) Rad. alone A) Surg. alone F) (Rad.+Chem.) AB) Surg.->Rad BA) Rad.->Surg. 9 4 FA) (Rad.+Chem.) >Surg. BC) Rad.->Chem. 3 6 CB) Chem.->Rad. 3 6 AF) Surg.-> (Rad.+Chem.) 4 5 CBA) Chem.->Rad. ->Surg. 5 C) Chem. alone 4 CA) Chem.->Surg. 3 FC) (Rad.+Chem.) 3 ->Chem. Others Unknown T-: T classification not defined. Rad.: radiotherapy. Surg.: surgery. Chem.: chemotherapy. Treatment methods in parentheses were given concurrently.

50 44 Treatment method T Tis T Ta Tb T T3 T4 TX T- Surgery ) Without ) With ) Unknown Radiotherapy ) Without ) With ) Unknown Chemotherapy ) Without ) With ) Unknown T-: T classification not defined. Carcinoma of the Larynx Cases Glottic Carcinoma Treatment Method for the Primary Lesion by T Classification Glottic Carcinoma Sequence of Treatment Methods for the Primary Lesion by T Classification Sequence of treatment methods T Tis T Ta Tb T T3 T4 TX T- No treatment B) Rad. alone F) (Rad.+Chem.) A) Surg. alone AB) Surg.->Rad BA) Rad.->Surg FA) (Rad.+Chem.) 3 7 ->Surg. BC) Rad.->Chem. 5 AF) Surg.-> (Rad.+Chem.) 3 CBA) Chem.->Rad. ->Surg. 3 CA) Chem.->Surg. Others 3 5 Unknown T-: T classification not defined. Rad.: radiotherapy. Chem.: chemotherapy. Surg.: surgery. Treatment methods in parentheses were given concurrently.

51 45 Treatment method T Tis T T T3 T4 TX T- Surgery ) Without ) With ) Unknown Radiotherapy ) Without ) With ) Unknown Chemotherapy ) Without ) With ) Unknown T-: T classification not defined. Carcinoma of the Larynx Cases Supraglottic Carcinoma Treatment Method for the Primary Lesion by T Classification Supraglottic Carcinoma Sequence of Treatment Methods for the Primary Lesion by T Classification Sequence of treatment methods T Tis T T T3 T4 TX T- No treatment 5 B) Rad. alone 3 37 A) Surg. alone F) (Rad.+Chem.) AB) Surg.->Rad. 4 8 BA) Rad.->Surg. 4 8 CB) Chem.->Rad. 3 6 FA) (Rad.+Chem.) ->Surg. 3 6 BAC) Rad.->Surg. ->Chem. C) Chem. alone FC) (Rad.+Chem.) ->Chem. Others 5 6 Unknown T-: T classification not defined. Rad.: radiotherapy. Surg.: surgery. Chem.: chemotherapy. Treatment methods in parentheses were given concurrently.

52 46 Treatment method T Tis T T T3 T4 TX T- Surgery ) Without 3 ) With 3 6 9) Unknown Radiotherapy ) Without 4 8 ) With 3 6 9) Unknown Chemotherapy ) Without 6 ) With 3 9) Unknown T-: T classification not defined. Carcinoma of the Larynx Cases Subglottic Carcinoma Treatment Method for the Primary Lesion by T Classification Subglottic Carcinoma Sequence of Treatment Methods for the Primary Lesion by T Classification Sequence of treatment methods T Tis T T T3 T4 TX T- No treatment A) Surg. alone 3 6 AB) Surg.->Rad. B) Rad. alone AC) Surg.->Chem. ACB) Surg.->Chem. ->Rad. AF) Surg. ->(Rad.+Chem.) Others Unknown T-: T classification not defined. Surg.: surgery. Rad.: radiotherapy. Chem.: chemotherapy. Treatment methods in parentheses were given concurrently.

53 47 Treatment method T Tis T T T3 T4 TX T- Surgery ) Without 4 ) With ) Unknown Radiotherapy ) Without 3 4 ) With ) Unknown Chemotherapy ) Without 3 6 ) With 3 7 9) Unknown Carcinoma of the Larynx Cases Carcinoma of the Larynx, NOS Treatment Method for the Primary Lesion by T Classification T-: T classification not defined. Carcinoma of the Larynx, NOS Sequence of Treatment Methods for the Primary Lesion by T Classification Sequence of treatment methods T Tis T T T3 T4 TX T- No treatment BA) Rad.->Surg. 3 C) Chem. alone CBA) Chem.->Rad. ->Surg. A) Surg. alone AB) Surg.->Rad. B) Rad. alone CA) Chem.->Surg. FAB) (Rad.+Chem.) ->Surg.->Rad. FC) (Rad.+Chem.) ->Chem. Others Unknown T-: T classification not defined. Rad.: radiotherapy. Surg.: surgery. Chem.: chemotherapy. Treatment methods in parentheses were given concurrently.

54 48 Surgical method Glottis Supraglottis Subglottis Larynx, NOS (C3.) (C3.) (C3.) (C3.9) H) No surgery C4) laryngectomy C9) Laryngectomy, other type C) Partial laryngectomy C4G) laryngectomy 8 with thyroid lobectomy C4G4) laryngectomy 4 7 with total thyroidectomy C3) Subtotal laryngectomy 4 C4G3) laryngectomy 3 with subtotal thyroidectomy CD) Partial laryngectomy with partial hypopharyngectomy C4DH6) Pharyngolaryngoesophagectomy H9)+ Others 4 4 Unknown Carcinoma of the Larynx Cases Surgical Method for the Primary Lesion by Subsite

55 49 Surgical method T Tis T T T3 T4 TX T- H) No surgery C4) laryngectomy C9) Laryngectomy, other type 7 3 C) Partial laryngectomy 4 C4G) laryngectomy with thyroid lobectomy C4G4) laryngectomy 6 7 with total thyroidectomy C3) Subtotal laryngectomy 3 4 C4G3) laryngectomy 3 with subtotal thyroidectomy CD) Partial laryngectomy with partial hypopharyngectomy C4DH6) Pharyngolaryngoesophagectomy H9)+ Others 3 4 Unknown T-: T classification not defined. Carcinoma of the Larynx Cases Surgical Method for the Primary Lesion by T Classification

56 5 Carcinoma of the Larynx Cases Glottic Carcinoma Surgical Method for the Primary Lesion by T Classification Surgical method T Tis T Ta Tb T T3 T4 TX T- H) No surgery C4) laryngectomy 9 4 C9) Laryngectomy, other type C) Partial laryngectomy C4G) laryngectomy 7 8 with thyroid lobectomy C3) Subtotal laryngectomy H9)+ Others 3 7 Unknown T-: T classification not defined.

57 5 Carcinoma of the Larynx Cases Supraglottic Carcinoma Surgical Method for the Primary Lesion by T Classification Surgical method T Tis T T T3 T4 TX T- H) No surgery C4) laryngectomy C4G) laryngectomy 3 7 with thyroid lobectomy C) Partial laryngectomy 3 4 C4G4) laryngectomy 4 4 with total thyroidectomy C9) Laryngectomy, other type 3 CD) Partial laryngectomy with partial hypopharyngectomy H9)+ Others 6 Unknown T-: T classification not defined.

58 5 Surgical method T Tis T T T3 T4 TX T- H) No surgery 3 C4) laryngectomy 4 C) Partial laryngectomy C4G4) laryngectomy with total thyroidectomy H9)+ Others 3 3 Unknown T-: T classification not defined. Carcinoma of the Larynx Cases Subglottic Carcinoma Surgical Method for the Primary Lesion by T Classification Carcinoma of the Larynx, NOS Surgical Method for the Primary Lesion by T Classification Surgical method T Tis T T T3 T4 TX T- H) No surgery 4 C4) laryngectomy 5 C4G) laryngectomy with thyroid lobectomy H9)+ Others Unknown T-: T classification not defined.

59 53 Carcinoma of the Larynx Cases Treatment Method for the Cervical Lymph Nodes by Subsite Treatment method Glottis Supraglottis Subglottis Larynx, NOS (C3.) (C3.) (C3.) (C3.9) Surgery ) Without ) With ) Unknown Radiotherapy ) Without ) With ) Unknown 4 5 Chemotherapy ) Without ) With ) Unknown Neck Dissection on the Ipsilateral Side by Subsite Neck dissection ) No N.D. ) Radical N.D. ) Conservative N.D. 3) Upper N.D. 4) Partial N.D. 5) Enucleation 8) Others 9) Unknown Glottis Supraglottis Subglottis Larynx, NOS (C3.) (C3.) (C3.) (C3.9) N.D.: neck dissection.

60 54 Carcinoma of the Larynx Cases Neck Dissection on the Contralateral Side by Subsite Neck dissection ) No N.D. ) Radical N.D. ) Conservative N.D. 3) Upper N.D. 4) Partial N.D. 5) Enucleation 8) Others 9) Unknown Glottis Supraglottis Subglottis Larynx, NOS (C3.) (C3.) (C3.) (C3.9) N.D.: neck dissection. Reconstructive surgery Reconstructive Surgery by Subsite Glottis Supraglottis Subglottis Larynx, NOS (C3.) (C3.) (C3.) (C3.9) ) No reconstruction B) Free jejunal flap 5 4) DP flap 3 D) Free RA MC flap 3 ) Local skin flap 3) Mucosal flap 5) PM MC flap C) Free FA flap F) Free scapular OC flap 8)+ Others 3 4 9) Unknown RA: rectus abdominis. PM: pectoralis major. OC: osteocutaneous. DP: deltopectoral. MC: musculocutaneous. FA: forearm.

61 55 Type of radiotherapy Carcinoma of the Larynx Cases Radiotherapy by Subsite Glottis Supraglottis Subglottis Larynx, NOS (C3.) (C3.) (C3.) (C3.9) ) No radiotherapy ) X-ray ) Electron beam ) 6 Co γ-ray 4 5 3) X-ray + electron beam ) 6 Co γ-ray + X-ray 8)+ Others 9) Unknown Chemotherapy by Subsite Route of Administration ) No chemotherapy ) Intravenous ) Intraarterial 3) Oral 8) Others 9) Unknown Glottis Supraglottis Subglottis Larynx, NOS (C3.) (C3.) (C3.) (C3.9)

62 56 Hypopharynx () 389 Cases

63 57 Carcinoma of the Hypopharynx Cases Subsite Subsite Postcricoid Pyriform sinus Posterior Hypopharynx, NOS Number of patients 34 ( 8.7%) ( 7.%) ( 4.4%) ( 5.7%) 389 (.%) Age Distribution by Gender Age Unknown Male Female Unknown

64 58 Carcinoma of the Hypopharynx Cases Histological Distribution by Subsite Histologic type Neoplasm, malig. Ca., undiff., NOS S.C.C. in situ, NOS S.C.C., NOS S.C.C., kerat., NOS S.C.C., large cell, nonkerat. S.C.C., small cell, nonkerat. Pyriform Postcricoid sinus (C3.) (C.9) Posterior (C3.) Hypopharynx, NOS (C3.9) Ca.: carcinoma. S.C.C.: squamous cell carcinoma. nonkerat.: nonkeratinizing. malig.: malignant. undiff.: undifferentiated. kerat.: keratinizing. T and N Status N N N Na Nb Nc N3 NX N- T Tis T 4 * 5 3 * 36 T 4 7 * 3 9 ** * 3 T ** 5 T4 5 * 3 33 ** 4 * 9 94 TX T M: cases. Each * signifies one M case. T-: T classification not defined. N-: N classification not defined.

65 59 Treatment method Postcricoid Pyriform Posterior Hypopharynx, sinus NOS (C3.) (C.9) (C3.) (C3.9) Surgery ) Without ) With ) Unknown Radiotherapy ) Without ) With ) Unknown Chemotherapy ) Without ) With ) Unknown Carcinoma of the Hypopharynx Cases Treatment Method for the Primary Lesion by Subsite Treatment Method for the Cervical Lymph Nodes by Subsite Treatment method Postcricoid Pyriform Posterior Hypopharynx, sinus NOS (C3.) (C.9) (C3.) (C3.9) Surgery ) Without ) With ) Unknown Radiotherapy ) Without ) With ) Unknown 6 9 Chemotherapy ) Without ) With ) Unknown

66 6 Carcinoma of the Hypopharynx Cases Sequence of Treatment Methods for the Primary Lesion by Subsite Sequence of treatment methods Postcricoid Pyriform Posterior Hypopharynx, sinus NOS (C3.) (C.9) (C3.) (C3.9) No treatment 3 5 A) Surg. alone F) (Rad.+Chem.) B) Rad. alone AB) Surg.->Rad. 3 5 FA) (Rad.+Chem.)->Surg. 5 3 BA) Rad.->Surg CAB) Chem.->Surg.->Rad. 4 CB) Chem.->Rad. 4 ABC) Surg.->Rad.->Chem. CA) Chem.->Surg. 8 CF) Chem.->(Rad.+Chem.) 5 9 AC) Surg.->Chem. 6 8 AF) Surg.->(Rad.+Chem.) 4 6 BAC) Rad.->Surg.->Chem. 6 6 FAB) (Rad.+Chem.)->Surg.->Rad. 5 BC) Rad.->Chem. 3 C) Chem. alone 3 CFA) Chem.->(Rad.+Chem.)->Surg. 3 FAC) (Rad.+Chem.)->Surg.->Chem. 3 Others Unknown Surg.: surgery. Rad.: radiotherapy. Chem.: chemotherapy. Treatment methods in parentheses were given concurrently.

67 6 Surgical method Postcricoid Pyriform Posterior Hypopharynx, sinus NOS (C3.) (C.9) (C3.) (C3.9) H) No surgery DC4H6) Pharyngolaryngoesophagectomy DC4) pharyngolaryngectomy D) Partial hypopharyngectomy D) hypopharyngectomy 7 DC4G) pharyngolaryngectomy with thyroid lobectomy DC4G4) pharyngolaryngectomy with total thyroidectomy 9 3 DC) Partial hypopharyngectomy with partial laryngectomy 7 9 DC4H7) pharyngolaryngectomy with blunt esophagectomy 7 9 C4D) pharyngolaryngectomy 3 3 DBA) Partial hypopharyngectomy with partial resection of the posterior of the oropharynx 3 3 DC4) Partial hypopharyngectomy 3 3 with total laryngectomy H9)+ Others Unknown Carcinoma of the Hypopharynx Cases Surgical Method for the Primary Lesion by Subsite

68 6 Carcinoma of the Hypopharynx Cases Neck dissection Neck Dissection on the Ipsilateral Side by Subsite Postcricoid Pyriform sinus Posterior Hypopharynx, NOS (C3.) (C.9) (C3.) (C3.9) ) No N.D ) Radical N.D ) Conservative N.D ) Upper N.D. 4) Partial N.D. 8 5) Enucleation 8) Others 9) Unknown N.D.: neck dissection. Neck Dissection on the Contralateral Side by Subsite Neck dissection Postcricoid Pyriform sinus Posterior Hypopharynx, NOS (C3.) (C.9) (C3.) (C3.9) ) No N.D ) Radical N.D. 9 3 ) Conservative N.D ) Upper N.D. 4) Partial N.D ) Enucleation 8) Others 9) Unknown N.D.: neck dissection.

69 63 Carcinoma of the Hypopharynx Cases Reconstructive surgery Reconstructive Surgery by Subsite Postcricoid Pyriform sinus Posterior Hypopharynx, NOS (C3.) (C.9) (C3.) (C3.9) ) No reconstruction B) Free jejunal flap C) Free FA flap ) PM MC flap 7 9 7) Gastric pullup 3 4 D) Free RA MC flap 4 B7) Free jejunal flap + gastric pullup 3 3 ) Local skin flap 7B) Gastric pullup + free jejunal flap F) Free scapular OC flap 8)+ Others 3 5 9) Unknown FA: forearm. PM: pectoralis major. MC: musculocutaneous. RA: rectus abdominis. OC: osteocutaneous.

70 64 Carcinoma of the Hypopharynx Cases Type of radiotherapy Postcricoid Radiotherapy by Subsite Pyriform sinus Posterior Hypopharynx, NOS (C3.) (C.9) (C3.) (C3.9) ) No radiotherapy ) X-ray ) 6 Co γ-ray ) Electron beam 9 3) X-ray + electron beam 7 7 7) HDR B.T. with 6 Co 8)+ Others 9) Unknown B.T.: brachytherapy. HDR: high dose rate. Chemotherapy by Subsite Route of Administration ) No chemotherapy ) Intravenous ) Intraarterial 3) Oral 8) Others 9) Unknown Postcricoid Pyriform sinus Posterior Hypopharynx, NOS (C3.) (C.9) (C3.) (C3.9)