Systematic review of carcinoma arising in pharyngeal diverticula: A 112-year analysis

Afroze S. Khan, Raghav C. Dwivedi, Zishan Sheikh, Shahnawaz Khan, Ravi C. Dwivedi, Namita Kanwar, Nishant Agrawal, Mohammed Sultan Ui Hassan, Rehan Kazi, Peter Rhys-Evans

Research output: Contribution to journalReview articlepeer-review


Carcinoma is a rare complication of pharyngeal diverticula. There is a paucity of information about its incidence, presentation, management, and treatment outcomes. A systematic review and analysis of all reported cases has been carried out. Methods. A comprehensive literature search for pharyngeal diverticula carcinoma was performed from 1896 to 2008. Descriptive analyses were carried out by analyzing the absolute and relative frequencies. Comparison of groups was illustrated with Kaplan-Meier curves and tested statistically using the log-rank test. A cohort of 56 patients with benign pharyngeal diverticula was selected for comparison with the accumulated cohort of pharyngeal diverticula carcinoma, and a Fisher's exact test was carried out on the extracted clinical characteristics of this cohort to evaluate for differences between benign and malignant pharyngeal diverticula. Results. Forty-three articles reporting 60 cases satisfied the inclusion criteria. The mean age at presentation was 68.8 years (SD = 9.8 years). Five-year cancer-specific survival (CSS) rates for patients who underwent excision alone, excision + postoperative radiotherapy (PORT), and radiotherapy alone were 0.74 versus 0.63 versus 0.0, respectively (p = .39). Five-year CSS rates of patients <65 versus ≥65 years were 0.43 versus 0.78, respectively (p = .046). Conclusion. Irregular symptoms in benign diverticula should raise suspicion of malignancy. Management consists of surgical excision ± PORT.

Original languageEnglish (US)
Pages (from-to)1368-1375
Number of pages8
JournalHead and Neck
Issue number9
StatePublished - Sep 2014


  • Zenker's diverticulum
  • carcinoma
  • head and neck cancers
  • pharyngeal diverticula

ASJC Scopus subject areas

  • Otorhinolaryngology


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