"This area is rich in lymphatics which drain from the supraglottic larynx to cervical nodes. As such, the PES is at high risk of involvement of oropharyngeal and supraglottic laryngeal carcinomas. Additionally, it is important in staging as invasion of the PES automatically raises the TNM staging to T3 in oropharyngeal and supraglottic laryngeal carcinomas. PES involvement necessitates more aggressive surgical treatments with higher morbidity such as supraglottic or total laryngectomy, in contrast to more conservative treatment such as local resection or radiation therapy which may be considered when the PES is not involved."