1
|
Chiari F, Guarino P, Di Martino G, Caporale CD, Presutti L, Molteni G. Features related to temporary tracheotomy in patients undergoing Transoral Robotic Surgery (TORS) for supraglottic squamous cell cancer of the larynx: A systematic review. Am J Otolaryngol 2024; 45:104436. [PMID: 39068815 DOI: 10.1016/j.amjoto.2024.104436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 07/22/2024] [Indexed: 07/30/2024]
Abstract
OBJECTIVE The aim of this systematic review is to assess a relation between demographical, clinical and tumoral features and the need for a prophylactic tracheotomy during TORS procedure in patients affected by supraglottic laryngeal cancer. METHODS PRISMA 2020 guidelines were applied in this systematic literature review. A computerized search was performed using the Embase/Pubmed, Scopus and Cochrane database, for articles published from 2007 to December 2023. A statistical univariate analysis including selected papers with low or intermediate risk of bias was performed. RESULTS Through a study selection process 8 full texts were eligible for statistical univariate analysis. The most relevant factor related to a prophylactic tracheotomy was a contextual bilateral cervical nodes dissection, which increased the need for a tracheotomy of about 3 times. Other factors contribute with a minor impact, such as a patients age >60 years at the time of the diagnosis, a cervical lymph node metastasis and a false vocal fold involvement. Each ones increase by 20-70 % the need for a tracheotomy. However, this rate is decreased by about 60 % by the epiglottis involvement. CONCLUSIONS The prophylactic tracheotomy is considered a temporary protection strategy to achieve a valid recovery after TORS procedure. However, there are no guidelines regarding its routinely use. Only 25 % of patients undergone tracheotomy during TORS to treat supraglottic laryngeal cancer. These preliminary results may add more significant evidence regarding the use of tracheotomy during the TORS procedure, in order possibly to help the surgeon decide preoperatively whether to perform it or not.
Collapse
Affiliation(s)
- Francesco Chiari
- Otolaryngology and Audiology - IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant'Orsola, Bologna, Italy
| | - Pierre Guarino
- Otolaryngology Head and Neck Unit - "Santo Spirito" Hospital, Pescara, Italy.
| | - Giuseppe Di Martino
- Department of Medicine and Ageing Sciences, "G. d'Annunzio" University of Chieti Pescara, Pescara, Italy; Unit of Hygiene, Epidemiology and Public Health, Local Health Authority of Pescara, Pescara, Italy
| | | | - Livio Presutti
- Otolaryngology and Audiology - IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant'Orsola, Bologna, Italy
| | - Gabriele Molteni
- Otolaryngology and Audiology - IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant'Orsola, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, Università di Bologna, Bologna, Italy
| |
Collapse
|
2
|
Ushiro K, Watanabe Y, Kishimoto Y, Kawai Y, Fujimura S, Asato R, Tsujimura T, Hori R, Kumabe Y, Yasuda K, Tamaki H, Iki T, Kitani Y, Kurata K, Kojima T, Takata K, Kada S, Takebayashi S, Shinohara S, Hamaguchi K, Miyazaki M, Ikenaga T, Maetani T, Harada H, Haji T, Omori K. Impact of cervical lymph node metastasis on transoral surgery for hypopharyngeal squamous cell carcinoma: A retrospective multicenter study. Head Neck 2024; 46:1913-1921. [PMID: 38294099 DOI: 10.1002/hed.27666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 12/11/2023] [Accepted: 01/19/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Hypopharyngeal carcinoma is likely to spread to the lymph nodes, but there is no established strategy for management in transoral surgery. METHODS We compared oncologic and functional outcomes in a retrospective multicenter study of patients who underwent transoral surgery for hypopharyngeal carcinoma between 2015 and 2021. RESULTS Two-hundred and thirty-two patients were included. Comparing patients with and without adjuvant radiotherapy, 3-year regional recurrence-free survival (RRFS) was not significantly different in pN2b and pN2c, but was significantly worse in pN3b without adjuvant radiotherapy. In patients without neck dissection, the 3-year RRFS was 85.6%, 76.8%, and 70.0% for T1, T2, and T3 primary lesions, respectively, and was significantly worse for T2 or higher (p = 0.035). CONCLUSIONS In the absence of extracapsular invasion, regional control did not deteriorate without adjuvant therapy. If prophylactic neck dissection is not performed, careful follow-up is necessary if the primary lesion is T2 or greater.
Collapse
Affiliation(s)
- Koji Ushiro
- Department of Otolaryngology - Head & Neck Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Yoshiki Watanabe
- Department of Otolaryngology - Head & Neck Surgery, Japanese Red Cross Osaka Hospital, Osaka, Japan
| | - Yo Kishimoto
- Department of Otolaryngology - Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yoshitaka Kawai
- Department of Otolaryngology - Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shintaro Fujimura
- Department of Otolaryngology - Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ryo Asato
- Department of Otolaryngology - Head & Neck Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Takashi Tsujimura
- Department of Otolaryngology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Ryusuke Hori
- Department of Otolaryngology - Head and Neck Surgery, University of Occupational and Environmental Health, Kitakyushu, Japan
- Department of Otolaryngology - Head & Neck Surgery, Fujita Health University, Toyoake, Japan
- Department of Otolaryngology - Head & Neck Surgery, Tenri Hospital, Tenri, Japan
| | - Yohei Kumabe
- Department of Otolaryngology - Head & Neck Surgery, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Kaori Yasuda
- Department of Otolaryngology - Head & Neck Surgery, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Hisanobu Tamaki
- Department of Otolaryngology - Head & Neck Surgery, Kurashiki Central Hospital, Kurashiki, Japan
| | - Takehiro Iki
- Department of Otolaryngology - Head & Neck Surgery, Kurashiki Central Hospital, Kurashiki, Japan
| | - Yoshiharu Kitani
- Department of Otolaryngology - Head & Neck Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Keisuke Kurata
- Department of Otolaryngology - Head & Neck Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Tsuyoshi Kojima
- Department of Otolaryngology - Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Otolaryngology - Head & Neck Surgery, Tenri Hospital, Tenri, Japan
| | - Kuniaki Takata
- Department of Otolaryngology - Head & Neck Surgery, Tenri Hospital, Tenri, Japan
| | - Shinpei Kada
- Department of Otolaryngology - Head & Neck Surgery, Japanese Red Cross Otsu Hospital, Otsu, Japan
| | - Shinji Takebayashi
- Department of Otolaryngology - Head & Neck Surgery, Shiga General Hospital, Moriyama, Japan
| | - Shogo Shinohara
- Department of Otolaryngology - Head & Neck Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Kiyomi Hamaguchi
- Department of Otolaryngology - Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Otolaryngology - Head & Neck Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Masakazu Miyazaki
- Department of Otolaryngology - Head & Neck Surgery, Nara Prefecture General Medical Center, Nara, Japan
| | - Tadashi Ikenaga
- Department of Otolaryngology - Head & Neck Surgery, Nara Prefecture General Medical Center, Nara, Japan
| | - Toshiki Maetani
- Department of Otolaryngology - Head & Neck Surgery, Medical Research Institute, Kitano Hospital, Osaka, Japan
| | - Hiroyuki Harada
- Department of Otolaryngology - Head & Neck Surgery, Medical Research Institute, Kitano Hospital, Osaka, Japan
| | - Tomoyuki Haji
- Department of Otolaryngology - Head & Neck Surgery, Kurashiki Central Hospital, Kurashiki, Japan
| | - Koichi Omori
- Department of Otolaryngology - Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| |
Collapse
|
3
|
Casanueva R, López F, García-Cabo P, Álvarez-Marcos C, Llorente JL, Rodrigo JP. Oncological and functional outcomes of transoral laser surgery for hypopharyngeal carcinoma. Eur Arch Otorhinolaryngol 2023; 280:829-837. [PMID: 36056169 PMCID: PMC9849286 DOI: 10.1007/s00405-022-07622-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 08/16/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND Surgical resection or radiotherapy (RT) are standard approaches for early-staged hypopharyngeal squamous cell carcinoma (HPSCC). Transoral laser microsurgery (TOLMS) seems to provide good oncological and functional results with few local complications. The aim of our study was to analyze the outcomes of TOLMS, with or without neck dissection or RT, in the treatment of HPSCC in a tertiary referral center. METHODS A retrospective study was conducted in patients with early T-category (T1-T2) HPSCC treated by TOLMS. RESULTS A total of 34 patients were included in the study. The series includes 17 (50%) T1 and 17 (50%) T2 classified tumors. The 5-year overall survival and disease-specific survival rates were 51% and 66%, respectively, with a 5-year local control rate of 92%. All patients reassumed oral diet and none of them had a tracheostomy at the end of the follow-up. CONCLUSIONS TOLMS offers an effective treatment option in terms of oncologic control and function preservation in locally circumscribed HPSCC.
Collapse
Affiliation(s)
- Rodrigo Casanueva
- Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, Avenida de Roma, s/n, 33011, Oviedo, Spain
| | - Fernando López
- Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, Avenida de Roma, s/n, 33011, Oviedo, Spain.
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain.
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), ISCIII, Madrid, Spain.
- Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain.
| | - Patricia García-Cabo
- Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, Avenida de Roma, s/n, 33011, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), ISCIII, Madrid, Spain
- Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain
| | - César Álvarez-Marcos
- Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, Avenida de Roma, s/n, 33011, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), ISCIII, Madrid, Spain
- Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain
| | - José Luis Llorente
- Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, Avenida de Roma, s/n, 33011, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), ISCIII, Madrid, Spain
- Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain
| | - Juan Pablo Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, Avenida de Roma, s/n, 33011, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), ISCIII, Madrid, Spain
- Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain
| |
Collapse
|
4
|
Treating Head and Neck Cancer in the Age of Immunotherapy: A 2023 Update. Drugs 2023; 83:217-248. [PMID: 36645621 DOI: 10.1007/s40265-023-01835-2] [Citation(s) in RCA: 44] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2023] [Indexed: 01/17/2023]
Abstract
Most patients diagnosed with head and neck squamous cell carcinoma (HNSCC) will present with locally advanced disease, requiring multimodality therapy. While this approach has a curative intent, a significant subset of these patients will develop locoregional failure and/or distant metastases. The prognosis of these patients is poor, and therapeutic options other than palliative chemotherapy are urgently needed. Epidermal growth factor receptor (EGFR) overexpression is an important factor in the pathogenesis of HNSCC, and a decade ago, the EGFR targeting monoclonal antibody cetuximab was approved for the treatment of late-stage HNSCC in different settings. In 2016, the anti-programmed death-1 (PD-1) immune checkpoint inhibitors nivolumab and pembrolizumab were both approved for the treatment of patients with recurrent or metastatic HNSCC with disease progression on or after platinum-containing chemotherapy, and in 2019, pembrolizumab was approved for first-line treatment (either as monotherapy in PD-L1 expressing tumors, or in combination with chemotherapy). Currently, trials are ongoing to include immune checkpoint inhibition in the (neo)adjuvant treatment of HNSCC as well as in novel combinations with other drugs in the recurrent/metastatic setting to improve response rates and survival and help overcome resistance mechanisms to immune checkpoint blockade. This article provides a comprehensive review of the management of head and neck cancers in the current era of immunotherapy.
Collapse
|
5
|
Wang L, Liu D, Sun R, Jiang Z, Yue J. Therapeutic effect on pyriform sinus carcinoma resection via paraglottic space approach. Front Surg 2023; 9:1068754. [PMID: 36684295 PMCID: PMC9852770 DOI: 10.3389/fsurg.2022.1068754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 11/29/2022] [Indexed: 01/09/2023] Open
Abstract
Objective To analyse the surgical indications, surgical efficacy and key influencing factors of prognosis of using a novel surgical approach for pyriform sinus carcinoma resection utilising the paraglottic space. Methods From 2014 to 2017, 93 patients with squamous cell carcinoma originating in the pyriform sinus were resected through the paraglottic space approach. The postoperative laryngeal function preservation, complications, survival rate and prognostic factors were analysed. Results All patients were followed up for more than 5 years. The 2, 3 and 5 year overall survival rates of the patients were 77.2%, 61.6% and 47.4%, respectively. The univariate analysis of survival rate showed that primary tumour T stage and N stage had a statistically significant effect on the survival rate of patients (P = 0.047 and P < 0.001, respectively). Multivariate analysis with the Cox regression model revealed that N stage is an independent risk factor for postoperative survival (P = 0.042). The preservation rate of laryngeal function was 65.6% (61/93). Pharyngeal fistula incidence was 4.3% (4/93). Systemic distant metastasis and second primary cancer were found to be the main causes of death. Conclusions As a novel surgical approach for the resection of pyriform sinus carcinoma, the paraglottic space approach can better expose the tumour, effectively improve the retention rate of laryngeal function, reduce the incidence of pharyngeal fistula and result in the better recovery of postoperative swallowing function with satisfactory long-term survival. N stage is an independent risk factor for postoperative survival.
Collapse
|
6
|
Evaluation of chronological changes in videofluorographic findings after transoral videolaryngoscopic surgery to reveal mechanism of dysphagia. Auris Nasus Larynx 2022; 50:374-382. [PMID: 36075789 DOI: 10.1016/j.anl.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 08/05/2022] [Accepted: 08/12/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Transoral surgery preserves good swallowing function in most cases, however, postoperative dysphagia sometimes leads to fatal complication such as aspiration pneumonia. We investigated the chronological changes in swallowing function have not been revealed relationship with dysphagia. The primary aim of this study was to reveal the mechanism of dysphagia following transoral surgery by analyzing chronological videofluorography (VF) findings. Moreover, the secondary aim of this study was to evaluate the relationship between mechanism of dysphagia and risk factors of patients to clarify the risk for dysphagia lead to prevention of postoperative complications. METHODS 22 patients who underwent transoral videolaryngoscopic surgery (TOVS) for either supraglottic or hypopharyngeal cancer were evaluated swallowing function. We performed VF during the preoperative, postoperative acute, and stable phases and investigated the chronological changes in the VF findings. The following parameters were evaluated by VF: horizontal distance of laryngeal movement, vertical distance of laryngeal elevation, laryngeal elevation delay time (LEDT), Bolus Residue Scale (BRS) scores, and Penetration Aspiration Scale (PAS) scores. Additionally, we evaluated risk factors for postoperative aspiration by investigating relationships between preoperative VF parameters, age of patients, history of radiation therapy, resection area, tumor (T) stage, postoperative Numeric Rating Scale (NRS), and PAS and BRS scores. RESULTS The median time at which oral feeding was resumed in this study was 9 (2-200) days. The patients who had postoperative acute PAS scores of 4 and above exhibited delays in resuming oral ingestion after surgery. TOVS did not impair laryngeal elevation and LEDT; however, the BRS and PAS scores temporarily worsened in the acute phase compared to the preoperative scores. These scores almost recovered to their preoperative states in the stable phase, and both the BRS and PAS scores worsened and recovered concurrently. Patients who exhibited poor vertical distance in laryngeal elevation as observed via preoperative VF or who had histories of radiation therapy had worse PAS scores in postoperative acute phase VF. Patients with broad resection areas had worse BRS scores in postoperative acute phase VF. CONCLUSION TOVS didn't impair the function of laryngeal elevation and elicitation of the swallowing reflex whereas pharyngeal bolus clearance, laryngeal penetration, and aspiration temporarily deteriorated concurrently but eventually almost recovered to their baseline values. Patients with histories of radiotherapy, poor laryngeal elevation, and broad resection areas are at the risk of postoperative dysphagia after TOVS. Patients with these risk factors need appropriate evaluation before resuming postoperative oral intake.
Collapse
|
7
|
Lai KWK, Lai R, Lorincz BB, Wang CC, Chan JYK, Yeung DCM. Oncological and Functional Outcomes of Transoral Robotic Surgery and Endoscopic Laryngopharyngeal Surgery for Hypopharyngeal Cancer: A Systematic Review. Front Surg 2022; 8:810581. [PMID: 35464886 PMCID: PMC9021537 DOI: 10.3389/fsurg.2021.810581] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 12/30/2021] [Indexed: 11/30/2022] Open
Abstract
Objectives Hypopharyngeal carcinoma (HPC) is a head and neck carcinoma with poor prognosis. Traditional laryngopharyngectomy offered promising oncological outcomes at the cost of functional outcomes. The recent advent in transoral robotic surgery (TORS), an organ-preserving surgery, has opened up new perspectives in the treatment for HPC. Here, we evaluate minimally invasive organ preservation surgery [TORS and endoscopic laryngopharyngeal surgery (ELPS)] for HPC in terms of feasibility and oncological and functional outcomes. Methods This is a systematic review. Six databases [CUHK Full-Text Journals, Embase 1910 to 2021, Ovid Emcare, Ovid MEDLINE (R), CINAHL, PubMed] were searched for articles and primary studies for TORS and ELPS for HPC. Screening was completed using predefined inclusion or exclusion criteria. Results A total of 8 studies on TORS and 3 studies on ELPS were eventually chosen after full-text review. For studies on TORS, 61.3% of patients (84 out of 137) still survived at the last follow-up with a mean follow-up time of 23.20 months (range: 12.8–37.21 months). Severe intraoperative and postoperative complications have not been reported. No cases of TORS required a conversion to open surgery. Swallowing function was optimal postoperatively with only 6 patients eventually required a percutaneous endoscopic gastrostomy (PEG) for feeding. Disease-specific survival was taken as the parameter for the measurement of oncological outcomes. A total of 2 studies reported a disease-specific survival of 100% within their follow-up period of 1 and 1.5 years, respectively. Another 2 studies reported a 2-year DSS of 89 and 98%, respectively. A 5-year DSS of 100% in early stage and 74% in late stage were achieved in one study. Another study also reported a 5-year DSS of 91.7%. For studies of ELPS, a 5- and 3-year disease-specific survival of 100% were achieved in 2 studies. Patients who underwent ELPS had good postoperative swallowing function with no PEG placement. There were also no other fatal complications. Conclusions Both TORS and ELPS for HPC provide satisfactory long-term oncological and functional outcomes improving postoperative quality of life of patients.
Collapse
Affiliation(s)
- Katherine W. K. Lai
- Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Princes of Wales Hospital, Shatin, Hong Kong SAR, China
| | - Ronald Lai
- Affiliated Teaching Unit of the Chinese University of Hong Kong, Department of Ear, Nose, and Throat, United Christian Hospital, Kwun Tong, Hong Kong SAR, China
| | - Balazs B. Lorincz
- Department of ENT, Head, and Neck Surgery, Agaplesion Frankfurter Diakonie Kliniken, Bethanien and Markus Hospitals, Frankfurt am Main, Germany
| | - Chen-Chi Wang
- Department of Otolaryngology-Head and Neck Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Jason Y. K. Chan
- Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Princes of Wales Hospital, Shatin, Hong Kong SAR, China
- *Correspondence: Jason Y. K. Chan
| | - David C. M. Yeung
- Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Princes of Wales Hospital, Shatin, Hong Kong SAR, China
| |
Collapse
|
8
|
Chen L, Si Y, Lin P, Guan Z, Zhu W, Liang H, Cai Q. Surgical treatment of T2-3 posterior hypopharyngeal carcinoma with preservation of laryngeal function. Acta Otolaryngol 2021; 141:851-856. [PMID: 34459710 DOI: 10.1080/00016489.2021.1965211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Posterior hypopharyngeal carcinoma indicates a poor prognosis. Previous treatments predicted negative influence to the pronunciation and swallowing function. The present study focuses on improving survival rate while improving quality of life. AIM To investigate on the surgical techniques of the preservation of laryngeal function of posterior hypopharyngeal carcinoma. METHODS Eighteen patients with posterior hypopharyngeal carcinoma of T2-T3 were studied. All primary lesions were removed and the defects were repaired with the radial forearm free flap (RFFF). RESULTS The 3-year overall survival rate was 51.9%. All patients could maintain daily caloric intake by feeding orally, and remove the gastric tube 28-61 days after operation. Assessed swallowing function by Fiberoptic endoscopic evaluations of swallowing. When eating solid food, 66.67% patients had food residue; no food entered airway, and all patients had Penetration-Aspiration Scale of level 1. As for liquid, 11.11% patients had level 5, 16.67% level 4, 27.78% level 2 and 44.44% level 1. CONCLUSIONS By preserving the integrity of larynx and superior laryngeal nerve with repairing the defects of posterior wall of hypopharynx with RFFF, patients with T2 and T3 stage posterior hypopharyngeal carcinoma could live a better quality of life.
Collapse
Affiliation(s)
- Ling Chen
- Department of Otolaryngology-Head and Neck, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yu Si
- Department of Otolaryngology-Head and Neck, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Peiliang Lin
- Department of Otolaryngology-Head and Neck, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Zhong Guan
- Department of Otolaryngology-Head and Neck, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Wenying Zhu
- Department of Otolaryngology-Head and Neck, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Haifeng Liang
- Department of Otolaryngology-Head and Neck, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Qian Cai
- Department of Otolaryngology-Head and Neck, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| |
Collapse
|
9
|
Finegersh A, Voora RS, Panuganti B, Faraji F, Holsinger FC, Brumund KT, Coffey C, Califano J, Orosco RK. Robotic surgery may improve overall survival for T1 and T2 tumors of the hypopharynx: An NCDB cohort study. Oral Oncol 2021; 121:105440. [PMID: 34329867 DOI: 10.1016/j.oraloncology.2021.105440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 05/08/2021] [Accepted: 06/30/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Hypopharyngeal cancer is associated with poor survival. Robotic surgery is emerging as a treatment for hypopharyngeal tumors, but no rigorous data are available to assess its effect on survival. METHODS The National Cancer Database (NCDB) was used to identify patients with T1 and T2 hypopharyngeal tumors undergoing robotic surgery, laser surgery, and primary radiation with or without chemotherapy from 2010 to 2016. All adult patients with available staging and no distant metastasis were included. RESULTS We compared 57 patients undergoing robotic surgery, 236 undergoing laser surgery, and 5,742 undergoing primary radiation. Compared to laser surgery, patients undergoing robotic surgery were significantly more likely to have negative margins, neck dissection, lower incomes, and care at an academic center. Rates of robotic surgery also significantly increased from 2010 to 2015. After multivariate regression, robotic surgery was associated with significantly improved overall survival compared to laser surgery and primary radiation. CONCLUSION Robotic surgery improves overall survival for T1 and T2 hypopharyngeal tumors compared to laser surgery and primary radiation in this NCDB cohort. This effect may be mediated by decreased positive margin rates relative to laser surgery. Rates of hypopharyngeal robotic surgery are expected to increase with wider adoption of robotic platforms and may improve overall survival rates for hypopharyngeal cancer.
Collapse
Affiliation(s)
- Andrey Finegersh
- Division of Otolaryngology, Department of Surgery, University of California San Diego, San Diego, CA, USA
| | - Rohith S Voora
- Division of Otolaryngology, Department of Surgery, University of California San Diego, San Diego, CA, USA
| | - Bharat Panuganti
- Division of Otolaryngology, Department of Surgery, University of California San Diego, San Diego, CA, USA
| | - Farhoud Faraji
- Division of Otolaryngology, Department of Surgery, University of California San Diego, San Diego, CA, USA
| | | | - Kevin T Brumund
- Division of Otolaryngology, Department of Surgery, University of California San Diego, San Diego, CA, USA; Division of Otolaryngology, Department of Surgery, VA San Diego Health System, La Jolla, CA, USA; Moores Cancer Center, La Jolla, CA, USA
| | - Charles Coffey
- Division of Otolaryngology, Department of Surgery, University of California San Diego, San Diego, CA, USA; Division of Otolaryngology, Department of Surgery, VA San Diego Health System, La Jolla, CA, USA; Moores Cancer Center, La Jolla, CA, USA
| | - Joseph Califano
- Division of Otolaryngology, Department of Surgery, University of California San Diego, San Diego, CA, USA; Moores Cancer Center, La Jolla, CA, USA
| | - Ryan K Orosco
- Division of Otolaryngology, Department of Surgery, University of California San Diego, San Diego, CA, USA; Moores Cancer Center, La Jolla, CA, USA.
| |
Collapse
|
10
|
Boscolo Nata F, Gardenal N, Giudici F, Tirelli G. The role of NBI with flexible video-endoscope in the follow-up of head and neck cancer patients: a prospective study. Eur Arch Otorhinolaryngol 2021; 279:2133-2141. [PMID: 34304298 DOI: 10.1007/s00405-021-07016-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/21/2021] [Indexed: 01/04/2023]
Abstract
PURPOSE Narrow band imaging (NBI) enhances mucosal vasculature and could help in the identification of recurrences. We assessed the effectiveness of NBI with flexible video-endoscope in the early detection of recurrence after treatment of head and neck squamous cell carcinoma, its diagnostic advantage over high-definition white-light (HD WL) endoscopy, also in relation to recurrence site, and the influence of previous radiotherapy (RT) or chemotherapy (CT). Moreover, we investigated the association between index tumor site and the risk of developing recurrence, and the relation between index tumor site and recurrence site. METHODS From January 2018 to November 2020, 160 patients previously treated with surgery and/or RT ± CT were evaluated using NBI with flexible video-endoscope. Sensitivity, specificity, positive/negative predictive value, and accuracy were calculated for NBI and HD WL, and compared using the McNemar test. The Fisher exact test was used to compare the other associations investigated. RESULTS The difference between NBI and HD WL sensitivity was statistically significant (p < 0.001). The NBI diagnostic advantage was 62.5%, highest in the hypopharynx (p = 0.05), and was not influenced by previous RT or CT (p = 0.49). Index tumor site statistically related with recurrence site (p < 0.001), but not with the risk of developing recurrence (p = 0.81). CONCLUSION NBI with flexible video-endoscope could represent a valid option to detect recurrence early during the follow-up, especially in a difficult-to-visualize site such as the hypopharynx.
Collapse
Affiliation(s)
- Francesca Boscolo Nata
- ENT Clinic, Head and Neck Department, Azienda Sanitaria Universitaria Giuliano Isontina, Strada di Fiume 447, 34149, Trieste, Italy.
| | - Nicoletta Gardenal
- ENT Clinic, Head and Neck Department, Azienda Sanitaria Universitaria Giuliano Isontina, Strada di Fiume 447, 34149, Trieste, Italy
| | - Fabiola Giudici
- Unit of Biostatistics, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Giancarlo Tirelli
- ENT Clinic, Head and Neck Department, Azienda Sanitaria Universitaria Giuliano Isontina, Strada di Fiume 447, 34149, Trieste, Italy
| |
Collapse
|
11
|
Use of Supraclavicular Flap by End to Side Technique in Pharyngeal SCC: A Case Report and Review of Literature. Case Rep Otolaryngol 2021; 2021:6619916. [PMID: 34336336 PMCID: PMC8298143 DOI: 10.1155/2021/6619916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 03/19/2021] [Accepted: 07/09/2021] [Indexed: 11/17/2022] Open
Abstract
Objectives In recent years, conservation laryngeal surgeries, including partial pharyngectomy, have been introduced as an alternative procedure for selected cases of hypopharyngeal squamous cell carcinoma (HSCC). Reconstruction of these defects presents a considerable challenge for the surgeon after partial pharyngectomy due to its circumferential nature. In this case report, we represent the innovative "End to side" technique to reconstruct hypopharyngeal defect using the rolled supraclavicular flap after laryngeal-preserving partial pharyngectomy. Methods and Results A 70-year-old female presented with a history of progressive dysphagia and odynophagia. The evaluations revealed a T3N0M0 SCC of pyriform sinus. The mass was successfully resected through partial pharyngectomy, and the hypopharyngeal defect reconstruction was achieved using the rolled supraclavicular flap via the "End to side" technique. The patient was discharged after decannulation on day 10. The 3-week barium swallow was performed with no evidence of anastomotic leakage, and the oral feeding was started after NG tube removal. At week 5, complete movement of the true vocal cord on the one side and good phonation and deglutition was observed. There was no evidence of recurrence after 1 year. Conclusions Laryngeal-preserving partial pharyngectomy and hypopharyngeal reconstruction with the rolled supraclavicular flap via the "End to side" technique could lead to good oncological and functional outcomes in selected cases of pyriform sinus.
Collapse
|
12
|
Yasumatsu R, Manako T, Jiromaru R, Hashimoto K, Wakasaki T, Matsuo M, Nakagawa T. Clinical Management of Early-Stage Hypopharyngeal Squamous Cell Carcinoma: A Single-Institution Clinical Analysis. EAR, NOSE & THROAT JOURNAL 2021:1455613211013084. [PMID: 33909487 DOI: 10.1177/01455613211013084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Early detection of hypopharyngeal squamous cell carcinoma (SCC) is important for both an improved prognosis and less-invasive treatment. We retrospectively analyzed the detection rates of early hypopharyngeal SCCs according to the evaluation methods and the clinical management of early hypopharyngeal SCCs. METHODS Sixty-eight patients with early hypopharyngeal SCC who were diagnosed were reviewed. RESULTS The number of early hypopharyngeal cancer patients with asymptomatic or synchronous or metachronous esophageal cancer examined by upper gastrointestinal endoscopy with narrow-band imaging (NBI) was significantly higher than those examined by laryngopharyngeal endoscopy with NBI. The 3-year disease-specific survival rates according to T classification were as follows: Tis, 100%; T1, 100%; T2, 79.8%; and overall, 91.2%, respectively. CONCLUSIONS Early-stage hypopharyngeal SCC can be cured by minimally invasive transoral surgery or radiotherapy. Observation of the pharynx using NBI in patients with a history of head and neck cancer, esophageal cancer, gastric cancer, or pharyngeal discomfort is very important, and routinely examining the pharynx with NBI, even in patients undergoing endoscopy for screening purposes, is recommended.
Collapse
Affiliation(s)
- Ryuji Yasumatsu
- Department of Otorhinolaryngology, Graduate School of Medical sciences, 12923Kyushu University, Fukuoka, Japan
| | - Tomomi Manako
- Department of Otorhinolaryngology, Graduate School of Medical sciences, 12923Kyushu University, Fukuoka, Japan
| | - Rina Jiromaru
- Department of Otorhinolaryngology, Graduate School of Medical sciences, 12923Kyushu University, Fukuoka, Japan
| | - Kazuki Hashimoto
- Department of Otorhinolaryngology, Graduate School of Medical sciences, 12923Kyushu University, Fukuoka, Japan
| | - Takahiro Wakasaki
- Department of Otorhinolaryngology, Graduate School of Medical sciences, 12923Kyushu University, Fukuoka, Japan
| | - Mioko Matsuo
- Department of Otorhinolaryngology, Graduate School of Medical sciences, 12923Kyushu University, Fukuoka, Japan
| | - Takashi Nakagawa
- Department of Otorhinolaryngology, Graduate School of Medical sciences, 12923Kyushu University, Fukuoka, Japan
| |
Collapse
|
13
|
Iizuka T, Kikuchi D, Suzuki Y, Tanaka M, Takeda H. Clinical relevance of endoscopic treatment for superficial pharyngeal cancer: feasibility of techniques corresponding to each location and long-term outcomes. Gastrointest Endosc 2021; 93:818-827. [PMID: 32721490 DOI: 10.1016/j.gie.2020.07.039] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 07/14/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Superficial pharyngeal cancers are being detected and treated using endoscopy in many medical facilities with increasing frequency. However, the reports focus on the hypopharynx. We identified reliable treatments by adapting the method for each region of the pharynx. Here, we introduce our methods for treating various pharyngeal regions and show their long-term results. METHODS Of 308 consecutive patients who underwent pharyngeal endoscopic submucosal dissection between February 2007 and December 2018 at our institution, we selected 293 patients who were diagnosed histologically with squamous cell carcinoma. The patients were divided into 4 groups based on the specific location of superficial pharyngeal lesions and the short- and long-term outcomes, such as technical success, adverse events, overall survival, and case-specific survival, were evaluated. RESULTS The procedure time was 51 minutes at location A where cancer develops most commonly. The rate of en bloc resection was 99.4%, and the R0 resection rate was 82.6%. With regard to adverse events, there were 2 cases of postoperative hemorrhage, both treated with endoscopic hemostasis. The average observation period was 61.2 months overall, with 14 cases of recurrent lymph node metastasis. The 5-year survival rate was 84.1%, and cause-specific survival was 100%. CONCLUSIONS Adaptation of the treatment method according to the location of the lesion led to good results. Endoscopic treatment of superficial pharyngeal cancer is both feasible and beneficial.
Collapse
Affiliation(s)
- Toshiro Iizuka
- Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan; Department of Gastrointestinal Endoscopy, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Daisuke Kikuchi
- Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
| | - Yugo Suzuki
- Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
| | - Masami Tanaka
- Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
| | - Hidehiko Takeda
- Department of Otolaryngology, Toranomon Hospital, Tokyo, Japan
| |
Collapse
|
14
|
Kim D, Kim N, Koh S, Chung MK, Son YI, Oh D, Jeong HS, Ahn YC. Oncological and Functional Outcomes of Larynx-preserving Surgery for Hypopharyngeal Cancer: A Comparison with Definitive Radiation-based Treatment. Cancer Res Treat 2021; 54:84-95. [PMID: 33781050 PMCID: PMC8756124 DOI: 10.4143/crt.2020.1197] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 03/24/2021] [Indexed: 12/27/2022] Open
Abstract
Purpose Larynx-preserving surgery (LPS) have recently gained popularity and achieved comparable oncologic outcomes to conventional radical surgery for localized hypopharyngeal cancer (HPC). In the current study, the role of LPS has been assessed thoroughly in comparison with upfront radiation therapy (RT). Materials and Methods We retrospectively reviewed 185 candidates for LPS with cT1–2 disease; 59 patients underwent upfront LPS while 126 patients received upfront RT, respectively. Oncological and functional outcomes were investigated and compared. Results Following LPS, safe margin (≥ 5 mm) was achieved in 37.3% of patients. Overall, better clinical outcomes at 5 years were achieved following upfront LPS than those following upfront RT: overall survival (OS) (72.7% vs. 59.0%, p=0.045), disease-free survival (DFS) (59.8% vs. 45.0%, p=0.039), and functional laryngeal preservation (100% vs. 89.7%, p=0.010). Although similar outcomes were observed in patients with cT1 disease, better 5-year DFS was achieved following upfront LPS in patients with cT2 disease (57.0% vs. 36.4%, p=0.023) by virtue of better local control. Despite frequent cN2–3 disease in upfront LPS group, comparable outcomes were observed between upfront RT and LPS group. However, multivariable analyses revealed that performance status and double primary cancer diagnosed within 6 months of HPC diagnosis affected OS significantly, while treatment modality per se did not. Conclusion Although upfront LPS could provide better local control than upfront RT in patients with cT2 disease, overall outcomes were comparable following either modality. Treatment selection of larynx-preserving approach for HPC should be individualized based on tumor and patient factors.
Collapse
Affiliation(s)
- Donghyeok Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Nalee Kim
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sungmin Koh
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Man Ki Chung
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young-Ik Son
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dongryul Oh
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Han-Sin Jeong
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yong Chan Ahn
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| |
Collapse
|
15
|
Shin J, Lee J, Hwang N, Choi SY, Park W, Choi N, Son YI, Cho J, Jeong HS. Tumor dimension-dependent microscopic extensions of hypopharyngeal cancer: Therapeutic implications for larynx-preserving hypopharyngectomy. J Surg Oncol 2021; 123:872-880. [PMID: 33497489 DOI: 10.1002/jso.26386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 01/10/2021] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Hypopharyngeal cancer (HPC) is well characterized by the early submucosal spread of cancer cells into adjacent subsites of the hypopharynx and deep tissues, advocating a wide extent of treatment. However, the microscopic extensions (ME) from gross tumors, according to the primary tumor dimensions, has not been reported in detail. METHODS We included patients who underwent upfront curative surgery, and retrospectively reviewed pathology specimens from 45 HPC cases. The distance of the MEs, defined as tumor infiltration beyond the gross tumor border on the submucosal and deep sides, was measured. We analyzed potential correlations between MEs and various physical tumor factors. RESULTS A rough linear correlation between the submucosal ME and the maximal diameter of tumors was found (p < .001, r2 = 0.225). Deep MEs did not correlate with tumor physical factors. However, the MEs differed significantly by the T status (p = .033 and .015 in submucosal and deep sides). In T1-2 tumors, the submucosal MEs were less than 0.5 cm, whereas those of T3-4 tumors were 1.5-2.0 cm. CONCLUSION In HPC, local MEs beyond the gross tumor border correlated with primary tumor T status. Our findings support that the surgical safety margin for HPC can be adjusted according to tumor dimension.
Collapse
Affiliation(s)
- Joongbo Shin
- Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Jiyeon Lee
- Department of Pathology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Nayoung Hwang
- Biostatistics and Future Medicine, Samsung Biomedical Research Institute, Samsung Medical Center, Korea
| | - Sung Yong Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Woori Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Nayeon Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Young-Ik Son
- Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Junhun Cho
- Department of Pathology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Han-Sin Jeong
- Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| |
Collapse
|
16
|
Li Y, Lu T, Hu G. Gene sequencing and expression of Raf-1 in lymphatic metastasis of hypopharyngeal carcinoma. Cancer Biomark 2021; 28:181-191. [PMID: 32224526 DOI: 10.3233/cbm-191238] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE We performed differential gene screening for lymphatic metastasis of hypopharyngeal carcinoma by gene sequencing. We also aimed to investigate the expression and clinicopathological significance of the screened gene in hypopharyngeal carcinoma lymphatic metastasis. METHODS The clinicopathological characteristics of 98 patients with hypopharyngeal carcinoma were collected to make survival analysis by Kaplan-Meier & log-rank test. Six cases of tumor tissues from patients with or without lymphatic metastasis were used for gene sequencing of differentially expressed genes. The most frequently differently expressed genes were validated by RT-PCR and Western blot in another 20 patients diagnosed for hypopharyngeal carcinoma. A total of 70 cases of hypopharyngeal carcinoma tumor tissues and normal tissues were investigated to examine the immunohistochemical expression and to explore the prognostic value by Kaplan-Meier & log-rank test and Cox's test. RESULTS Lymphatic metastasis has been proved to cause a reduction in postoperative survival of patients with hypopharyngeal carcinoma. The results of gene sequencing analysis showed that Raf-1 was a differentially expressed gene in lymphatic metastasis of hypopharyngeal carcinoma. Moreover, the expression of Raf-1 was significantly up-regulated in tumor tissues of lymphatic metastasis patients compared to non-lymphatic metastasis tumor tissues and normal tissues. Meanwhile, Raf-1 had been verified to be an independent risk factor affecting the prognosis of hypopharyngeal carcinoma. CONCLUSIONS For the first time, we investigated Raf-1 as an independent prognostic risk factor of lymphatic metastasis in hypopharyngeal carcinoma. It suggests that Raf-1 may serve as an important potential biomarker in preventing and diagnosing lymphatic metastasis in patients with hypopharyngeal carcinoma and improving the prognosis of patients.
Collapse
|
17
|
Crary MA. Dysphagia and Head and Neck Cancer. Dysphagia 2021. [DOI: 10.1016/b978-0-323-63648-3.00005-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
18
|
Hassid S, Van der Vorst S, Delahaut G, Ambroise J, Lawson G. Transoral robotic surgery hypopharyngectomy (TORSH): feasibility and outcomes. Eur Arch Otorhinolaryngol 2020; 277:2883-2892. [DOI: 10.1007/s00405-020-05984-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/13/2020] [Indexed: 02/05/2023]
|
19
|
Gong Z, Hu G. PCDH20 acts as a tumour-suppressor gene through the Wnt/β-catenin signalling pathway in hypopharyngeal squamous cell carcinoma. Cancer Biomark 2020; 26:209-217. [PMID: 31450490 DOI: 10.3233/cbm-190442] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Downregulation of PCDH20 is frequently involved in tumorigenesis of many cancers, but the role of PCDH20 protein in hypopharyngeal squamous cell carcinoma (HSCC) is still unknown. OBJECTIVE The aim of this study was to investigate the role of PCDH20 in hypopharyngeal squamous cell carcinoma (HSCC). METHODS Immunohistochemistry (IHC) and qRT-PCR was carried out to estimate the expressions of PCDH20 protein and mRNA in HSCC tissues and adjacent non-tumor tissues. Correlation between the PCDH20 expression and clinicopathological characteristics was evaluated using chi-square test. Meanwhile, Kaplan-Meier method and log-rank test were applied to analyze the overall survival. After transfection of PCDH20, the CCK8 assay, Cell migration assay and invasion assay were used to investigate the changes in the viability, migration and invasion of Fuda cells. The mechanisms by which reduced PCDH20 promote migration and invasion of Fuda cells were examined using western blotting. RESULTS PCDH20 protein showed in tumor tissue low expression rates of 67.5% (54/80). The mRNA of PCDH20 indicated the consistent trend (80%, 8/10). Reduced PCDH20 expression was positively related to T stage and lymph node metastasis (P< 0.05). Patients with low levels of PCDH20 had worse overall survival compared with those with high PCDH20 levels (P< 0.001). The univariate Cox regression analysis described that lymph node metastasis (P= 0.043) and down-regulated PCDH20 expression (P= 0.045) were significantly prognostic factors.Multivariate analysis suggested that low PCDH20 expression (P= 0.015) were significantly independent prognostic factors for overall survival. PCDH20 in Fadu cells significantly inhibited cell viability, migration and invasion. Meanwhile, PCDH20 was involved in the disruption of HSCC progression through antagonizing its downstream Wnt/β-catenin signalling pathway. CONCLUSION Our data highlight that the downregulated PCDH20 may serve as reliable diagnostic biomarker in HSCC.
Collapse
|
20
|
Lane C, Rabbani R, Linton J, Taylor SM, Viallet N. Systematic review and meta-analysis of transoral laser microsurgery in hypopharyngeal carcinoma. Laryngoscope Investig Otolaryngol 2020; 5:66-73. [PMID: 32128432 PMCID: PMC7042655 DOI: 10.1002/lio2.351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 12/15/2019] [Accepted: 12/31/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Transoral laser microsurgery has been suggested as an alternative treatment modality for hypopharyngeal carcinoma. The purpose of this study is to systematically review the oncologic and functional outcomes of patients with hypopharyngeal carcinoma when treated with primary transoral laser microsurgery. METHODS A comprehensive literature search was performed using PRISMA methodology on OVID MEDLINE and EMBASE. Meta-analysis was completed for oncological outcomes. RESULTS Six studies reported quality of life outcomes five reported oncologic outcomes. A median of 95% (range 0.83-0.98) patients achieving gastrostomy independence, a median of 3% (range 0%-6%) were tracheostomy dependent, and a median of 97% (Range 0.89-1.0) were able to preserve their larynx. Pooled five-year overall survival was 54% (CI, 0.50-0.58, I2 = 29%), pooled disease-specific survival was 72% (CI, 0.68-0.77, I2 = 46%), and pooled local control rate was 78% (CI, 0.72-0.85, I2 = 69%). CONCLUSION Systematic review supports improvements in functional outcomes and oncologic outcomes with transoral laser microsurgery.
Collapse
Affiliation(s)
- Ciaran Lane
- Department of Otolaryngology ‐ Head and Neck SurgeryUniversity of ManitobaWinnipegCanada
| | - Rasheda Rabbani
- George & Fay Yee Center for Healthcare Innovation, Max Rady College of Medicine, Rady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
- Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health SciencesUniversity of ManitobaWinnipegManitobaCanada
| | - Janice Linton
- Neil John Maclean Health SciencesUniversity of Manitoba LibrariesWinnipegManitobaCanada
| | - S. Mark Taylor
- Division of Otolaryngology‐Head and Neck SurgeryDalhousie UniversityHalifax Regional MunicipalityNova ScotiaCanada
| | - Norbert Viallet
- Department of Otolaryngology ‐ Head and Neck SurgeryUniversity of ManitobaWinnipegCanada
| |
Collapse
|
21
|
Hochfelder CG, McGinn AP, Mehta V, Castellucci E, Kabarriti R, Ow TJ. Treatment sequence and survival in locoregionally advanced hypopharyngeal cancer: A surveillance, epidemiology, and end results-based study. Laryngoscope 2019; 130:2611-2621. [PMID: 31821572 DOI: 10.1002/lary.28452] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 07/26/2019] [Accepted: 11/17/2019] [Indexed: 01/20/2023]
Abstract
OBJECTIVES/HYPOTHESIS The objective of this study was to examine the association between modality of primary treatment and survival among patients with locoregionally advanced hypopharyngeal cancer. STUDY DESIGN Retrospective cohort. METHODS There were 2,328 adult patients diagnosed with stage III or IV, M0, hypopharyngeal squamous cell carcinoma identified within the Surveillance, Epidemiology and End Results (SEER) registry (years 2004-2015). Patients who received primary chemoradiation (CRT) were compared to those who received surgery with either adjuvant radiation therapy (S + RT), or surgery with adjuvant CRT (S + CRT). The latter primary surgery group (S + Adj) was also analyzed collectively. Overall survival (OS) and disease-specific survival (DSS) were assessed using Kaplan-Meier analyses and Cox regression models using a propensity score to adjust for factors associated with treatment allocation. RESULTS Median survival was 20 months (interquartile range [IQR] = 10-45) with CRT and 25 months (IQR = 10-47) with S + Adj (P < .001). S + Adj had higher-grade cancers and more advanced T staging (P < .001). S + CRT was associated with longer OS (hazard ratio [HR] = 0.70, 95% confidence interval [CI]: 0.59-0.84) and DSS (HR = 0.66, 95% CI: 0.54-0.82) after adjusting for age, gender, race, subsite, grade, and stage. S + RT was associated with longer DSS than CRT (HR = 0.75, 95% CI: 0.57-0.99) but not OS (HR = 0.82, 95% CI: 0.66-1.04). S + Adj was associated with longer DSS in T1/T2 disease (P = .04) and T4 disease (P = .0003), but did not reach significance among patients with T3 disease (P = .06). CONCLUSIONS Among patients with advanced hypopharyngeal cancer reported in the SEER database, treatment with S + Adj was associated with longer DSS and OS compared to those treated with primary CRT. LEVEL OF EVIDENCE 2b Laryngoscope, 130:2611-2621, 2020.
Collapse
Affiliation(s)
- Colleen G Hochfelder
- Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A
| | - Aileen P McGinn
- Department of Epidemiology and Population Health, Bronx, New York, U.S.A
| | - Vikas Mehta
- Department of Otorhinolaryngology-Head and Neck Surgery, Bronx, New York, U.S.A
| | | | - Rafi Kabarriti
- Department of Radiation Oncology, Bronx, New York, U.S.A
| | - Thomas J Ow
- Department of Otorhinolaryngology-Head and Neck Surgery, Bronx, New York, U.S.A.,Department of Pathology, Bronx, New York, U.S.A
| |
Collapse
|
22
|
Grasl S, Janik S, Parzefall T, Formanek M, Grasl MC, Heiduschka G, Erovic BM. Lymph node ratio as a prognostic marker in advanced laryngeal and hypopharyngeal carcinoma after primary total laryngopharyngectomy. Clin Otolaryngol 2019; 45:73-82. [PMID: 31660699 DOI: 10.1111/coa.13468] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 09/27/2019] [Accepted: 10/21/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND We evaluated the prognostic value of lymph node ratio (LNR) in patients with advanced laryngeal and hypopharyngeal squamous cell carcinoma. STUDY DESIGN Retrospective chart review. METHODS Between 1994 and 2018, 79 patients underwent total laryngopharyngectomy and adjuvant therapy. LNR was determined and statistically compared to patients' overall survival (OS), disease-specific survival (DSS), disease-free survival (DFS), locoregional and distant failure. RESULTS The 5-year OS, DSS and DFS rates were 45.6%, 73.4% and 56.9%, respectively. 24.1% and 25.3% developed loco- regional failure or distant metastatic disease, respectively. Univariate analyses showed that high LNR (cut-off >0.07) was significantly associated with distant and locoregional failure. On multivariate analysis, LNR remained an independent predictor for OS (P = .004), DSS (P = .009) and DFS (P = .044). CONCLUSION Increased LNR in patients with advanced laryngeal or hypopharyngeal carcinoma is significantly linked to shortened OS, DSS, DFS and higher locoregional and distant metastatic disease.
Collapse
Affiliation(s)
- Stefan Grasl
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Stefan Janik
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Thomas Parzefall
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Michael Formanek
- Department of Otorhinolaryngology and Phonetics, Hospital of St. John of God, Vienna, Austria.,Department of Laryngology, Medical School, Sigmund Freud Private University, Vienna, Austria
| | - Matthaeus C Grasl
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Gregor Heiduschka
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Boban M Erovic
- Institute of Head and Neck Diseases, Evangelical Hospital Vienna, Vienna, Austria
| |
Collapse
|
23
|
Cortese S, Muratori E, Mastronicola R, Roch M, Beulque E, Rauch P, Dekerle L, Deganello A, Dolivet G. Partial pharyngolaryngectomy with infrahyoid flap: Our experience. Am J Otolaryngol 2019; 40:102271. [PMID: 31445929 DOI: 10.1016/j.amjoto.2019.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 07/27/2019] [Accepted: 08/02/2019] [Indexed: 10/26/2022]
Abstract
AIM We evaluated a cohort of advanced hypopharyngeal squamous cell carcinoma, treated with conservative surgery, reconstruction with infrahyoid flap and radio-chemotherapy. METHODS We used partial pharyngo-laryngectomy and radio-chemotherapy to treat fifty-seven patients with stage III-IV hypopharyngeal SCC from November 1994 to December 2011. Clinical examination and speech therapy evaluation were used for estimation of laryngeal function. RESULTS All patients received a partial pharyngo-laryngectomy. All patients underwent neck dissection; 56 patients received bilateral neck dissection. Reconstruction was achieved by infra-hyoid flap. Five-year overall and disease-specific survival rates were 54.4% and 61.4%, respectively. Successful laryngeal function preservation with complete five-year remission was achieved in 44% of the patients. CONCLUSION Selected even if advanced carcinomas of the hypopharynx maybe treated with partial pharyngo-laryngectomy with reconstruction with pedicled flap. Both oncological and functional results showed a good outcome.
Collapse
|
24
|
Dulguerov P, Broglie MA, Henke G, Siano M, Putora PM, Simon C, Zwahlen D, Huber GF, Ballerini G, Beffa L, Giger R, Rothschild S, Negri SV, Elicin O. A Review of Controversial Issues in the Management of Head and Neck Cancer: A Swiss Multidisciplinary and Multi-Institutional Patterns of Care Study-Part 1 (Head and Neck Surgery). Front Oncol 2019; 9:1125. [PMID: 31709185 PMCID: PMC6822016 DOI: 10.3389/fonc.2019.01125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 10/09/2019] [Indexed: 11/23/2022] Open
Abstract
Background: The Head and Neck Cancer Working Group of Swiss Group for Clinical Cancer Research (SAKK) has investigated the level of consensus (LOC) and discrepancy in everyday practice of diagnosis and treatment in head and neck cancer. Materials and Methods: An online survey was iteratively generated with 10 Swiss university and teaching hospitals. LOC below 50% was defined as no agreement, while higher LOC were arbitrarily categorized as low (51-74%), moderate (75-84%), and high (≥85%). Results: Any LOC was achieved in 62% of topics (n = 60). High, moderate and low LOC were found in 18, 20, and 23%, respectively. Regarding Head and Neck Surgery, Radiation Oncology, Medical Oncology, and biomarkers, LOC was achieved in 50, 57, 83, and 43%, respectively. Conclusions: Consensus on clinical topics is rather low for surgeons and radiation oncologists. The questions discussed might highlight discrepancies, stimulate standardization of practice, and prioritize topics for future clinical research.
Collapse
Affiliation(s)
- Pavel Dulguerov
- Department of Otorhinolaryngology, Head and Neck Surgery, Geneva University Hospital, Geneva, Switzerland
| | - Martina A. Broglie
- Department of Otorhinolaryngology, Head and Neck Surgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Guido Henke
- Department of Radiation Oncology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Marco Siano
- Department of Medical Oncology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
- Department of Medical Oncology, Hôpital Riviera-Chablais, Vevey, Switzerland
| | - Paul Martin Putora
- Department of Radiation Oncology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christian Simon
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Lausanne, Lausanne, Switzerland
| | - Daniel Zwahlen
- Department of Radiation Oncology, Cantonal Hospital Graubünden, Chur, Switzerland
- Department of Radiation Oncology, Cantonal Hospital of Winterthur, Winterthur, Switzerland
| | - Gerhard F. Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Giorgio Ballerini
- Department of Radiation Oncology, Clinica Luganese SA, Lugano, Switzerland
| | - Lorenza Beffa
- Department of Radiation Oncology, Cantonal Hospital Lucerne, Lucerne, Switzerland
| | - Roland Giger
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Sacha Rothschild
- Department of Medical Oncology, University Hospital of Basel, Basel, Switzerland
| | - Sandro V. Negri
- Department of Otorhinolaryngology, Lindenhofspital, Bern, Switzerland
| | - Olgun Elicin
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| |
Collapse
|
25
|
Tirelli G, Gardenal N, Gatto A, Bonini P, Tofanelli M, Fernández-Fernández MM. Is there a role for ultrasonic surgery in transoral laryngeal cancer resections? Expert Rev Med Devices 2019; 16:275-279. [DOI: 10.1080/17434440.2019.1596795] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Giancarlo Tirelli
- ENT Clinic, Head and Neck Department, University of Trieste, Trieste, Italy
| | - Nicoletta Gardenal
- ENT Clinic, Head and Neck Department, University of Trieste, Trieste, Italy
| | - Annalisa Gatto
- ENT Clinic, Head and Neck Department, University of Trieste, Trieste, Italy
| | - Pierluigi Bonini
- ENT Clinic, Head and Neck Department, University of Trieste, Trieste, Italy
| | | | | |
Collapse
|
26
|
The Emerging Role of Robotic Surgery among Minimally Invasive Surgical Approaches in the Treatment of Hypopharyngeal Carcinoma: Systematic Review and Meta-Analysis. J Clin Med 2019; 8:jcm8020256. [PMID: 30781660 PMCID: PMC6406881 DOI: 10.3390/jcm8020256] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 02/11/2019] [Accepted: 02/12/2019] [Indexed: 12/12/2022] Open
Abstract
The aim of this systematic review with meta-analysis was to investigate the available literature on transoral approaches in the treatment of hypopharyngeal squamous cell carcinoma, with a special focus on transoral robotic surgery (TORS). A systematic review was conducted according to the PRISMA (preferred reporting items for systematic reviews and meta-analyses) check-list, and 15 studies were included. Five of the included studies evaluated TORS, while ten studies focused on transoral laser microsurgery (TLM) for the treatment of early or advanced stage hypopharyngeal cancer. Overall, survival rates of TLM and TORS studies, analyzed together in the cumulative meta-analysis, were 66.4% (95% confidence interval (CI) 54.3%–76.7%) at 36+ months of follow up. The TORS subgroup showed a higher cumulative survival rate (85.5%, 95% CI 55.8%–96.5%) compared to TLM (58.5%, 95% CI 46.6%–69.6%). Cumulative data showed that 29.3% (95% CI 24.0%–35.3%) of deaths were attributable to cancer. The results were similar between TLM and TORS studies. The larynx function preservation cumulative rate was 94.3% (95% CI 91.8%–96.1%). The results were similar among the two subgroups. The present review supports the use of transoral approaches in the treatment of hypopharyngeal cancer. TORS is oncologically sound and provides excellent functional results with low complication rates.
Collapse
|
27
|
Kwon DI, Miles BA. Hypopharyngeal carcinoma: Do you know your guidelines? Head Neck 2018; 41:569-576. [DOI: 10.1002/hed.24752] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Daniel I. Kwon
- Department of Otolaryngology-Head and Neck Surgery; Loma Linda University Health; Loma Linda California
| | - Brett A. Miles
- Department of Otolaryngology-Head and Neck Surgery; Icahn School of Medicine at Mount Sinai; New York New York
| | | |
Collapse
|
28
|
Garneau JC, Bakst RL, Miles BA. Hypopharyngeal cancer: A state of the art review. Oral Oncol 2018; 86:244-250. [DOI: 10.1016/j.oraloncology.2018.09.025] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 09/14/2018] [Accepted: 09/18/2018] [Indexed: 10/28/2022]
|
29
|
Park YM, Kim SH. ASO Author Reflections: Transoral Robotic Surgery Combined with Neoadjuvant Chemotherapy for Management of Advanced Laryngohypopharyngeal Cancer. Ann Surg Oncol 2018; 25:894-895. [PMID: 30288650 DOI: 10.1245/s10434-018-6850-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Indexed: 11/18/2022]
Affiliation(s)
- Young Min Park
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Se-Heon Kim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea.
| |
Collapse
|
30
|
Mazerolle P, Philouze P, Garrel R, Aubry K, Morinière S, El Bedoui S, Ton Van J, Ferron C, Malard O, Jegoux F, Berard E, Vergez S. Oncological and functional outcomes of trans-oral robotic surgery for pyriform sinus carcinoma: A French GETTEC group study. Oral Oncol 2018; 86:165-170. [PMID: 30409296 DOI: 10.1016/j.oraloncology.2018.09.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 09/10/2018] [Accepted: 09/13/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Pyriform sinus carcinomas (SCC) present specific functional and oncological issues. The recent advent of trans-oral robotic surgery (TORS), as a conservative procedure, has opened up new perspectives. OBJECTIVES To present the oncological and functional outcomes of TORS for pyriform sinus SCC. MATERIALS AND METHODS We included, retrospectively, all TORS procedures for pyriform sinus SCC performed between 2009 and 2017 in eight French tertiary referral centers. We excluded lesions involving the pyriform sinus that had developed from the oropharynx, larynx, or other anatomic sub-sites of the hypopharynx. RESULTS We included 57 TORS procedures. Median hospital stay was 10 days. A preventive tracheotomy was performed in seven cases (12%), and all were successfully decannulated. Oral re-feeding was possible for 93%, after a median of 5 days. The main surgical complications were hemorrhages (three cases), all successfully handled, although 2 patients with heavy comorbidities died from blood loss in the days after. Adjuvant therapy was proposed in 31 cases (54%), including two cases of salvage surgery (total pharyngolaryngectomy). After a median follow-up of 23 months, overall and disease-free survival were, respectively, 84% and 74% at 24 months, and 66% and 50% at 48 months. At the end of follow-up, organ preservation rate was 96%. None of the surviving patients needed a tracheotomy and oral diet was possible for 96%. CONCLUSION The functional and oncological outcomes of TORS for pyriform sinus cancer are encouraging, and this procedure can be considered safe for selected early or moderately advanced cases as a conservative treatment.
Collapse
Affiliation(s)
- Paul Mazerolle
- Department of Surgery, University Cancer Institute Toulouse-Oncopole University Hospital of Toulouse, 1 Avenue Irène Joliot-Curie, 31059 Toulouse, France
| | - Pierre Philouze
- Department of Head and Neck Surgery, Hospices Civils de Lyon, Lyon-Nord University Hospital, 103 Grande Rue de la Croix Rousse, 69000 Lyon, France
| | - Renaud Garrel
- Department of Head and Neck Surgery, Montpellier Guy De Chauliac University Hospital, 80 Avenue Augustin Fliche, 34000 Montpellier, France
| | - Karine Aubry
- Department of Head and Neck Surgery, Limoges Dupuytrens University Hospital, 2 Avenue Martin Luther King, 87000 Limoges, France
| | - Sylvain Morinière
- Department of Head and Neck Surgery, Tours Bretonneau University Hospital, 2 Boulevard Tonnellé, 37000 Tours, France
| | - Sophie El Bedoui
- Department of Head and Neck Surgery, Lille Oscar Lambret Cancer Care Center, 3 Rue Frederic Combemale, 59000 Lille, France
| | - Jean Ton Van
- Department of Head and Neck Surgery, Lille Oscar Lambret Cancer Care Center, 3 Rue Frederic Combemale, 59000 Lille, France
| | - Christophe Ferron
- Department of Head and Neck Surgery, Nantes University Hospital, 1 Place Alexis-Ricordeau, 44000 Nantes, France
| | - Olivier Malard
- Department of Head and Neck Surgery, Nantes University Hospital, 1 Place Alexis-Ricordeau, 44000 Nantes, France
| | - Franck Jegoux
- Department of Head and Neck Surgery, Rennes University Hospital, 2 Rue Henri Le Guilloux, 35000 Rennes, France
| | - Emilie Berard
- Department of Epidemiology, Health Economics and Public Health, UMR1027 INSERM-Toulouse University, Toulouse University Hospital (CHU), Toulouse, France
| | - Sébastien Vergez
- Department of Surgery, University Cancer Institute Toulouse-Oncopole University Hospital of Toulouse, 1 Avenue Irène Joliot-Curie, 31059 Toulouse, France.
| |
Collapse
|
31
|
Li Y, Liu C, Wang Z, Hu G. Expression of protocadherin8: Function as a tumor suppressor in hypopharyngeal carcinoma. Cancer Biomark 2018; 22:495-502. [DOI: 10.3233/cbm-171137] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
32
|
Breda E, Catarino R, Monteiro E. Transoral laser microsurgery as standard approach to hypopharyngeal cancer survival analysis in a hospital based population. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2018. [DOI: 10.1016/j.otoeng.2016.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
33
|
SEOM clinical guidelines for the treatment of head and neck cancer (2017). Clin Transl Oncol 2017; 20:75-83. [PMID: 29159792 PMCID: PMC5785598 DOI: 10.1007/s12094-017-1776-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 10/16/2017] [Indexed: 01/04/2023]
Abstract
Head and neck cancer (HNC) is defined as malignant tumours located in the upper aerodigestive tract and represents 5% of oncologic cases in adults in Spain. More than 90% of these tumours have squamous histology. In an effort to incorporate evidence obtained since 2013 publication, Spanish Society of Medical Oncology (SEOM) presents an update of HNC diagnosis and treatment guideline. The eighth edition of TNM classification, published in January 2017, introduces important changes for p16-positive oropharyngeal tumours, for lip and oral cavity cancer and for N3 category. In addition, there are new data about induction chemotherapy and the role of immunotherapy in HNC.
Collapse
|
34
|
Kishimoto Y, Sogami T, Uozumi R, Funakoshi M, Miyamoto SI, Kitamura M, Suzuki C, Muto M, Tateya I, Omori K. Complications After Endoscopic Laryngopharyngeal Surgery. Laryngoscope 2017; 128:1546-1550. [DOI: 10.1002/lary.26953] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 08/09/2017] [Accepted: 09/10/2017] [Indexed: 11/10/2022]
Affiliation(s)
- Yo Kishimoto
- Department of Otolaryngology-Head and Neck Surgery
| | - Tohru Sogami
- Department of Otolaryngology-Head and Neck Surgery
| | - Ryuji Uozumi
- Department of Biomedical Statistics and Bioinformatics
| | | | - Shin-ichi Miyamoto
- Department of Gastroenterology and Hepatology; Graduate School of Medicine, Kyoto University; Kyoto Japan
| | | | | | | | | | - Koichi Omori
- Department of Otolaryngology-Head and Neck Surgery
| |
Collapse
|
35
|
Hung LT, Huang HI, Wang LW, Yang MH, Chu PY. Oncologic results and quality of life in patients with squamous cell carcinoma of hypopharynx after transoral laser microsurgery. Lasers Surg Med 2017; 50:117-124. [DOI: 10.1002/lsm.22742] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2017] [Indexed: 12/14/2022]
Affiliation(s)
- Li-Ting Hung
- Department of Otolaryngology; Taipei Veterans General Hospital and National Yang-Ming University; Taipei Taiwan
| | - Hsin-I Huang
- Department of Otolaryngology; Taipei Veterans General Hospital and National Yang-Ming University; Taipei Taiwan
| | - Ling-Wei Wang
- Department of Oncology Medicine; Taipei Veterans General Hospital and National Yang-Ming University; Taipei Taiwan
| | - Muh-Hwa Yang
- Department of Oncology Medicine; Taipei Veterans General Hospital and National Yang-Ming University; Taipei Taiwan
| | - Pen-Yuan Chu
- Department of Otolaryngology; Taipei Veterans General Hospital and National Yang-Ming University; Taipei Taiwan
| |
Collapse
|
36
|
The long-term oncological and functional outcomes of transoral robotic surgery in patients with hypopharyngeal cancer. Oral Oncol 2017; 71:138-143. [DOI: 10.1016/j.oraloncology.2017.06.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 06/14/2017] [Accepted: 06/18/2017] [Indexed: 11/21/2022]
|
37
|
Imanishi Y, Ozawa H, Sakamoto K, Fujii R, Shigetomi S, Habu N, Otsuka K, Sato Y, Watanabe Y, Sekimizu M, Ito F, Tomita T, Ogawa K. Clinical outcomes of transoral videolaryngoscopic surgery for hypopharyngeal and supraglottic cancer. BMC Cancer 2017. [PMID: 28651556 PMCID: PMC5485567 DOI: 10.1186/s12885-017-3396-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background Transoral videolaryngoscopic surgery (TOVS) was developed as a new distinct surgical procedure for hypopharyngeal cancer (HPC) and supraglottic cancer (SGC) staged at up to T3. However, long-term treatment outcomes of TOVS remain to be validated. Methods Under a straight broad intraluminal view provided by combined use of a distending laryngoscope and a videolaryngoscope, we performed en bloc tumor resection via direct bimanual handling of the ready-made straight-form surgical instruments and devices. We retrospectively analyzed functional and oncologic outcomes of 72 patients with HPC (n = 58) or SGC (n = 14) whose minimum follow-up was 24 months or until death. Results The cohort comprised nine patients of Tis, 23 of T1, 33 of T2, and 7 of T3. Among 36 patients (50%) who underwent neck dissection simultaneously, all but one were pathologically node-positive. Twelve patients underwent postoperative concurrent chemoradiation (CCRT) as adjuvant treatment, and another four patients underwent radiation or CCRT for second or later primary cancer. The endotracheal tube was removed in an operation room in all but two patients who underwent temporary tracheostomy. Pharyngeal fistula was formed transiently in two patients. The median time until patients resumed oral intake and could take a soft meal was 2 and 5 days, respectively. Eventually, 69 patients (96%) took normal meals. The 5-year cause-specific survival (CSS), overall survival (OS), larynx-preserved CSS, and loco-regional controlled CSS were 87.3%, 77.9%, 86.0%, and 88.0%, respectively. Multivariate analysis revealed N2-3 as an independent prognostic factor in both CSS (hazard ratio [HR] = 25.51, P = 0.008) and OS (HR = 4.90, P = 0.022), which indirectly reflected higher risk of delayed distant metastasis. Conclusions Considering its sound functional and oncological outcomes with various practical advantages, TOVS can be a dependable, less invasive, and cost-effective surgical option of an organ-function preservation strategy for HPC and SGC.
Collapse
Affiliation(s)
- Yorihisa Imanishi
- Department of Otorhinolaryngology-Head and Neck Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan. .,Department of Otorhinolaryngology, Kawasaki Municipal Kawasaki Hospital, Kawasaki, Kanagawa, 210-0013, Japan.
| | - Hiroyuki Ozawa
- Department of Otorhinolaryngology-Head and Neck Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Koji Sakamoto
- Department of Otorhinolaryngology, Saiseikai Utsunomiya Hospital, Utsunomiya, Tochigi, 321-0974, Japan
| | - Ryoichi Fujii
- Department of Otorhinolaryngology, Saiseikai Yokohamashi Nanbu Hospital, Yokohama, Kanagawa, 234-0054, Japan
| | - Seiji Shigetomi
- Department of Otorhinolaryngology, Yokohama Municipal Citizen's Hospital, Yokohama, Kanagawa, 240-8555, Japan
| | - Noboru Habu
- Department of Otorhinolaryngology, Kyosai Tachikawa Hospital, Tachikawa, Tokyo, 190-0022, Japan
| | - Kuninori Otsuka
- Department of Otorhinolaryngology, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Kanagawa, 230-8765, Japan
| | - Yoichiro Sato
- Department of Otorhinolaryngology, Kawasaki Municipal Kawasaki Hospital, Kawasaki, Kanagawa, 210-0013, Japan
| | - Yoshihiro Watanabe
- Department of Otorhinolaryngology-Head and Neck Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Mariko Sekimizu
- Department of Otorhinolaryngology-Head and Neck Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Fumihiro Ito
- Department of Otorhinolaryngology-Head and Neck Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Toshiki Tomita
- Department of Otorhinolaryngology-Head and Neck Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Kaoru Ogawa
- Department of Otorhinolaryngology-Head and Neck Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| |
Collapse
|
38
|
Breda E, Catarino R, Monteiro E. Transoral laser microsurgery as standard approach to hypopharyngeal cancer. Survival analysis in a hospital based population. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2017; 69:1-7. [PMID: 28190450 DOI: 10.1016/j.otorri.2016.11.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 11/10/2016] [Accepted: 11/13/2016] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Cancer of the hypopharynx remains one of the most challenging chapters in head and neck oncology. The objective of this study is to ascertain the relevance of a transoral laser approach as a valid functional option for treatment of cancer of the hypopharynx in Portugal, and additionally, to confirm the reproducibility of survival and functional outcomes described in other reference centers. SUBJECTS AND METHODS The outcomes of 37 out of 60 patients presenting hypopharyngeal carcinoma primarily treated by TLM (transoral laser microsurgery) and neck dissection and or adjuvant treatment when needed, with curative intention in tertiary referral center, were retrospectively evaluated and compared with published results. RESULTS There were no patients in stage I. Three-year and five-year overall survival (Kaplan-Meier) were 83.5% and 63.5% for stage II (n=12), 57.1% (only 3-year overall survival evaluable for this stage) for stage III (n=7), and 53.1% and 39.8% for stage IVa (n=18), respectively. Five-year local control rates were 90% for stage II and 87.5% for stage IVa, respectively; only three-year local control rates were possible to evaluate for stage III, with a 100% control rate. Five-year total larynx preservation rate was 97.3%. CONCLUSIONS TLM, alone or with neck dissection and adjuvant therapy, is a valid procedure for treatment of hypopharyngeal cancer in different stages. Furthermore, this kind of approach can be replicated in different oncologic centers with similar oncologic and functional results.
Collapse
Affiliation(s)
- Eduardo Breda
- Department of Otolaryngology, Portuguese Institute of Oncology Dr Francisco Gentil, Porto, Portugal.
| | - Raquel Catarino
- Molecular Oncology GRP CI, Portuguese Institute of Oncology Dr Francisco Gentil, Porto, Portugal
| | - Eurico Monteiro
- Department of Otolaryngology, Portuguese Institute of Oncology Dr Francisco Gentil, Porto, Portugal
| |
Collapse
|
39
|
Hypopharyngeal cancer: United Kingdom National Multidisciplinary Guidelines. The Journal of Laryngology & Otology 2017; 130:S104-S110. [PMID: 27841124 PMCID: PMC4873926 DOI: 10.1017/s0022215116000529] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. With an age standardised incidence rate of 0.63 per 100 000 population, hypopharynx cancers account for a small proportion of the head and neck cancer workload in the UK, and thus suffer from the lack of high level evidence. This paper discusses the evidence base pertaining to the management of hypopharyngeal cancer and provides recommendations on management for this group of patients receiving cancer care.
Collapse
|
40
|
Tomifuji M, Araki K, Yamashita T, Shiotani A. Salvage Transoral Videolaryngoscopic Surgery for radiorecurrent hypopharyngeal and supraglottic cancer. Auris Nasus Larynx 2016; 44:464-471. [PMID: 27856033 DOI: 10.1016/j.anl.2016.10.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 09/16/2016] [Accepted: 10/19/2016] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To evaluate the feasibility of Transoral Videolaryngoscopic Surgery (TOVS) for radiorecurrent supraglottic and hypopharyngeal cancer, and to compare survival and complications between primary and radiorecurrent cases. METHODS Twelve cases of salvage TOVS for radiorecurrent cancer and 53 cases of TOVS as an initial treatment (primary cases) were evaluated. Days to resume soft diet, Functional Outcomes of Swallowing Scale (FOSS), postoperative complications, epithelization days and survival outcomes were assessed by retrospective chart review. RESULTS FOSS score was significantly worse in salvage cases compared with primary cases. Bleeding and airway compromise was slightly greater in salvage cases than in primary cases; however, this was not statistically significant. Wound healing was significantly delayed in salvage cases compared with primary cases (P<0.001). In primary cases, wounds were re-epithelized within 60 days in 83% of patients and within 90 days in almost all patients, while in salvage cases 42% of patients required more than 90 days for wound healing. In salvage cases, the 5-year overall survival, disease specific survival rate, local control rate, and laryngeal preservation rate was 85.7%, 85.7%, 62.5%, and 78.0%, respectively, and 85.7%, 98.0%, 91.3%, and 97.8%, respectively, for primary cases. Local control rate was significantly better in primary cases than in salvage cases. CONCLUSION Salvage TOVS was feasible in highly selected cases. After serial transoral surgery, the final laryngeal preservation rate was satisfactory. Swallowing function in salvage cases tended to be worse than in primary cases, and a significantly longer time was required for wound healing.
Collapse
Affiliation(s)
- Masayuki Tomifuji
- National Defense Medical College, Department of Otolaryngology - Head and Neck Surgery, Saitama, Japan.
| | - Koji Araki
- National Defense Medical College, Department of Otolaryngology - Head and Neck Surgery, Saitama, Japan
| | - Taku Yamashita
- Kitasato University School of Medicine, Department of Otorhinolaryngology - Head and Neck Surgery, Kanagawa, Japan
| | - Akihiro Shiotani
- National Defense Medical College, Department of Otolaryngology - Head and Neck Surgery, Saitama, Japan
| |
Collapse
|
41
|
Hall SF, Griffiths R. Did the addition of concomitant chemotherapy to radiotherapy improve outcomes in hypopharyngeal cancer? A population-based study. ACTA ACUST UNITED AC 2016; 23:266-72. [PMID: 27536177 DOI: 10.3747/co.23.3085] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND For oncologists and for patients, no site-specific clinical trial evidence has emerged for the use of concurrent chemotherapy with radiotherapy (ccrt) over radiotherapy (rt) alone for cancer of the hypopharynx (hpc) or for other human papilloma virus-negative head-and-neck cancers. METHODS This retrospective population-based cohort study using administrative data compared treatments over time (1990-2000 vs. 2000-2010), treatment outcomes, and outcomes over time in 1333 cases of hpc diagnosed in Ontario between January 1990 and December 2010. RESULTS The incidence of hpc is declining; the use of ccrt that began in 2001 is increasing; and the 3-year overall survival for all patients remains poor at 34.6%. No difference in overall survival was observed in a comparison of patients treated in the decade before ccrt and of patients treated in the decade during the uptake of ccrt. CONCLUSIONS The addition of ccrt to the armamentarium of treatment options for oncologists treating head-and-neck patients did not improve outcomes for hpc at the population level.
Collapse
Affiliation(s)
- S F Hall
- Department of Otolaryngology/Head and Neck Surgery, Kingston, ON
| | - R Griffiths
- ices Queen's, Queen's University, Kingston, ON
| |
Collapse
|
42
|
Jang JY, Kim EH, Cho J, Jung JH, Oh D, Ahn YC, Son YI, Jeong HS. Comparison of Oncological and Functional Outcomes between Initial Surgical versus Non-Surgical Treatments for Hypopharyngeal Cancer. Ann Surg Oncol 2016; 23:2054-61. [PMID: 26786092 DOI: 10.1245/s10434-016-5088-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND Whether to administer surgical or non-surgical treatments (radiation or chemoradiation therapies) for the initial management of hypopharyngeal cancer (HPC) remains a topic of debate. Herein, we explored the differences between the two approaches in terms of oncological and functional outcomes in 332 HPC patients. METHODS The primary endpoint was survival probability; secondary outcomes included post-treatment speech and swallowing functions and necessity of additional surgical procedures for salvage or complication management. Cox proportional hazard models using clinical variables were constructed to identify significant factors. RESULTS The 2- and 5-year overall survival (OS) rates in all patients were 64.9 and 40.9 %, respectively. In early-stage HPC patients (N = 52), initial surgery ± radiation therapy (RT) or RT alone yielded similar oncological (60 % 5-year OS rate) and functional outcomes. As for resectable advanced-stage cancers (N = 177), initial surgery ± RT/chemoradiation therapy (SRC) and initial concurrent chemoradiation therapy (iCRT) resulted in similar 45-50 % 5-year OS rates. After sacrificing the larynx, 60 % of SRC patients recovered their speaking ability through voice prosthesis, which was less than the rate for iCRT patients (76.6 %; p = 0.008). Additional surgical interventions were required in 28.0-28.6 % of patients in both groups; however, 60 % of patients undergoing additional surgery in the iCRT group received multiple (two or more) surgical interventions (p = 0.029). CONCLUSIONS Our data revealed similar oncological outcomes, but different functional outcomes, between initial surgical and non-surgical treatments for HPC. In resectable advanced-stage HPC, iCRT resulted in better verbal communication outcomes than SRC; however, more iCRT patients required multiple surgical interventions during clinical courses.
Collapse
Affiliation(s)
- Jeon Yeob Jang
- Department of Otorhinolaryngology-Head and Neck Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Eun-Hye Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jungkyu Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae-Hoon Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Dongryul Oh
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yong Chan Ahn
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young-Ik Son
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Han-Sin Jeong
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| |
Collapse
|
43
|
Dysphagia and Head and Neck Cancer. Dysphagia 2016. [DOI: 10.1016/b978-0-323-18701-5.00004-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
44
|
Hanaoka N, Ishihara R, Takeuchi Y, Suzuki M, Otozai S, Kida K, Yoshii T, Fujii T, Yoshino K, Sugawa T, Kitamura K, Kanemura R, Koike R, Uedo N, Higashino K, Akasaka T, Yamashina T, Kanesaka T, Matsuura N, Aoi K, Yamasaki Y, Hamada K, Iishi H, Tomita Y. Endoscopic submucosal dissection as minimally invasive treatment for superficial pharyngeal cancer: a phase II study (with video). Gastrointest Endosc 2015; 82:1002-8. [PMID: 26234696 DOI: 10.1016/j.gie.2015.06.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 06/11/2015] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Although endoscopic submucosal dissection (ESD) has been applied for superficial pharyngeal cancer, no prospective trials have been reported. To investigate the efficacy and safety of ESD for superficial pharyngeal cancer, we conducted a prospective phase II trial. METHODS Fifty-four patients with 73 lesions were enrolled from September 2010 to August 2014, and ESD was performed. The primary endpoint was the complete resection rate. Secondary endpoints were safety, recurrence-free survival, overall survival, and incidence of metachronous pharyngeal cancer. RESULTS Fifty-four patients had stage 0-III cancer: stage 0, n = 22; stage I, n = 14; stage II, n = 17; and stage III, n = 1. The en bloc resection rate was 100%, and the complete resection rate was 79.5% (58/73 lesions; 95% confidence interval, 68%-88%). No serious adverse events related to ESD were encountered. Four patients required nasogastric intubation and feeding. No patients required percutaneous endoscopic gastrostomy and tracheotomy. Swallowing, speech, and airway functions were preserved in all patients. One of the 54 patients died of an unrelated illness. Median follow-up was 27 months (range 6-55 months). Local cervical lymph node metastasis was observed in 1 patient, and the case was salvaged successfully with lymph node dissection. The 3-year overall and recurrence-free survival rates were 97.7% and 98.1%, respectively. Cumulative development of multiple cancers of the pharynx at 3 years was 18.4%. CONCLUSIONS ESD appears to be a safe and effective minimally invasive treatment in patients with superficial pharyngeal cancer. ( CLINICAL TRIAL REGISTRATION NUMBER UMIN000003623.).
Collapse
Affiliation(s)
- Noboru Hanaoka
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Ryu Ishihara
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Yoji Takeuchi
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Motoyuki Suzuki
- Department of Otorhinolaryngology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Shinji Otozai
- Department of Otorhinolaryngology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Kota Kida
- Department of Otorhinolaryngology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Tadashi Yoshii
- Department of Otorhinolaryngology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Takashi Fujii
- Department of Otorhinolaryngology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Kunitoshi Yoshino
- Department of Otorhinolaryngology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Toshimitsu Sugawa
- Department of Otorhinolaryngology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Koji Kitamura
- Department of Otorhinolaryngology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Ryo Kanemura
- Department of Otorhinolaryngology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Ryosuke Koike
- Department of Otorhinolaryngology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Noriya Uedo
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Koji Higashino
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Tomofumi Akasaka
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Takeshi Yamashina
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Takashi Kanesaka
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Noriko Matsuura
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Kenji Aoi
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Yasushi Yamasaki
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Kenta Hamada
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Hiroyasu Iishi
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Yasuhiko Tomita
- Department of Pathology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| |
Collapse
|
45
|
Lim GC, Holsinger FC, Li RJ. Transoral Endoscopic Head and Neck Surgery: The Contemporary Treatment of Head and Neck Cancer. Hematol Oncol Clin North Am 2015; 29:1075-92. [PMID: 26568549 DOI: 10.1016/j.hoc.2015.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Traditional open surgical approaches are indicated for treatment of select tumor subsites of head and neck cancer, but can also result in major cosmetic and functional morbidity. Transoral surgical approaches have been used for head and neck cancer since the 1960s, with their application continuing to evolve with the changing landscape of this disease and recent innovations in surgical instrumentation. The potential to further reduce treatment morbidity with transoral surgery, while optimizing oncologic outcomes, continues to be investigated. This review examines current literature evaluating oncologic and quality-of-life outcomes achieved through transoral head and neck surgery.
Collapse
Affiliation(s)
- Gil Chai Lim
- Department of Otolaryngology-Head and Neck Surgery, Jeju National University School of Medicine, 102 Jejudaehak-ro, Jeju Special Self-Governing Province 63243, Republic of Korea
| | - Floyd Christopher Holsinger
- Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, 875 Blake Wilbur Drive, Palo Alto, CA 94305-5820, USA
| | - Ryan J Li
- Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, 875 Blake Wilbur Drive, Palo Alto, CA 94305-5820, USA.
| |
Collapse
|
46
|
Wang CC, Liu SA, Wu SH, Wang CP, Liang KL, Jiang RS, Lin JC. Transoral robotic surgery for early T classification hypopharyngeal cancer. Head Neck 2015; 38:857-62. [PMID: 26559383 DOI: 10.1002/hed.24160] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2015] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND For hypopharyngeal cancer, transoral robotic surgery (TORS) has been reported as a new organ preserving treatment but outcomes are rarely reported. METHODS From 2010 to 2013, 10 patients with early T classification pyriform sinus cancer were selected to receive TORS and conventional neck dissection. The clinical parameters, including rates of adjuvant radiotherapy, survivals, as well as organ and function preservation, were retrospectively analyzed. RESULTS TORS was successful in all 10 patients, and 5 patients received adjuvant radiotherapy. After mean follow-up of 26 months, 1 patient died of distant metastasis and 1 patient died of other malignancy. There was no local recurrence and larynxes were all preserved. Eight surviving patients who were followed up continuously could receive oral intake and had a serviceable voice without tracheostomy or feeding tubes. CONCLUSION TORS is a feasible transoral approach for selected patients with early T classification hypopharyngeal cancer. The reported oncologic/functional outcomes are satisfactory. © 2015 Wiley Periodicals, Inc. Head Neck 38: 857-862, 2016.
Collapse
Affiliation(s)
- Chen-Chi Wang
- Department of Otolaryngology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,School of Speech Language Pathology and Audiology, Chung Shan Medical University, Taichung, Taiwan.,Department of Otolaryngology-Head and Neck Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Shih-An Liu
- Department of Otolaryngology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Otolaryngology-Head and Neck Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Shang-Heng Wu
- Department of Otolaryngology-Head and Neck Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ching-Ping Wang
- School of Speech Language Pathology and Audiology, Chung Shan Medical University, Taichung, Taiwan.,Department of Otolaryngology-Head and Neck Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Kai-Li Liang
- Department of Otolaryngology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Otolaryngology-Head and Neck Surgery, Taichung Veterans General Hospital, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Rong-San Jiang
- Department of Otolaryngology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Otolaryngology-Head and Neck Surgery, Taichung Veterans General Hospital, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Jin-Ching Lin
- Department of Otolaryngology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Radiation Oncology, Taichung Veterans General Hospital, Taichung, Taiwan
| |
Collapse
|
47
|
|
48
|
Tomifuji M, Araki K, Yamashita T, Mizokami D, Kamide D, Suzuki H, Miyagawa Y, Tanaka S, Taniai S, Shiotani A. Risk factors for dysphagia after transoral videolaryngoscopic surgery for laryngeal and pharyngeal cancer. Head Neck 2015; 38:196-201. [DOI: 10.1002/hed.23866] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2014] [Indexed: 11/11/2022] Open
Affiliation(s)
- Masayuki Tomifuji
- Department of Otolaryngology-Head and Neck Surgery; National Defense Medical College; Saitama Japan
| | - Koji Araki
- Department of Otolaryngology-Head and Neck Surgery; National Defense Medical College; Saitama Japan
| | - Taku Yamashita
- Department of Otolaryngology-Head and Neck Surgery; National Defense Medical College; Saitama Japan
| | - Daisuke Mizokami
- Department of Otolaryngology-Head and Neck Surgery; National Defense Medical College; Saitama Japan
| | - Daisuke Kamide
- Department of Otolaryngology-Head and Neck Surgery; National Defense Medical College; Saitama Japan
| | - Hiroshi Suzuki
- Department of Otolaryngology-Head and Neck Surgery; National Defense Medical College; Saitama Japan
| | - Yoshihiro Miyagawa
- Department of Otolaryngology-Head and Neck Surgery; National Defense Medical College; Saitama Japan
| | - Shingo Tanaka
- Department of Otolaryngology-Head and Neck Surgery; National Defense Medical College; Saitama Japan
| | - Shinichi Taniai
- Department of Otolaryngology-Head and Neck Surgery; National Defense Medical College; Saitama Japan
| | - Akihiro Shiotani
- Department of Otolaryngology-Head and Neck Surgery; National Defense Medical College; Saitama Japan
| |
Collapse
|
49
|
Kucur C, Durmus K, Dziegielewski PT, Ozer E. Transoral robot-assisted carbon dioxide laser surgery for hypopharyngeal cancer. Head Neck 2015; 37:743-5. [DOI: 10.1002/hed.23860] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 04/07/2014] [Accepted: 09/12/2014] [Indexed: 11/10/2022] Open
Affiliation(s)
- Cuneyt Kucur
- Department of Otolaryngology - Head and Neck Surgery; Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Comprehensive Cancer Center, The Ohio State University Wexner Medical Center; Columbus Ohio
- Department of Otolaryngology; Dumlupinar University; Kutahya Turkey
| | - Kasim Durmus
- Department of Otolaryngology - Head and Neck Surgery; Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Comprehensive Cancer Center, The Ohio State University Wexner Medical Center; Columbus Ohio
| | - Peter T. Dziegielewski
- Department of Otolaryngology - Head and Neck Surgery; Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Comprehensive Cancer Center, The Ohio State University Wexner Medical Center; Columbus Ohio
- Department of Otolaryngology; University of Florida; Gainesville Florida
| | - Enver Ozer
- Department of Otolaryngology - Head and Neck Surgery; Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Comprehensive Cancer Center, The Ohio State University Wexner Medical Center; Columbus Ohio
| |
Collapse
|
50
|
Feasibility and Clinical Outcomes of Transoral Robotic Surgery and Transoral Robot-Assisted Carbon Dioxide Laser for Hypopharyngeal Carcinoma. J Craniofac Surg 2015; 26:235-7. [DOI: 10.1097/scs.0000000000001185] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|