Long-term outcome of transoral organ-preserving pharyngeal endoscopic resection for superficial pharyngeal cancer.

Autor: Muto M; Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto, Japan., Satake H, Yano T, Minashi K, Hayashi R, Fujii S, Ochiai A, Ohtsu A, Morita S, Horimatsu T, Ezoe Y, Miyamoto S, Asato R, Tateya I, Yoshizawa A, Chiba T
Jazyk: angličtina
Zdroj: Gastrointestinal endoscopy [Gastrointest Endosc] 2011 Sep; Vol. 74 (3), pp. 477-84. Date of Electronic Publication: 2011 Jun 25.
DOI: 10.1016/j.gie.2011.04.027
Abstrakt: Background: Early detection of pharyngeal cancer has been difficult. We reported that narrow-band imaging (NBI) endoscopy can detect superficial pharyngeal cancer, and these lesions can be treated endoscopically.
Objective: To assess the safety and long-term efficacy of transoral organ-preserving pharyngeal endoscopic resection (TOPER) for superficial pharyngeal cancer.
Design and Setting: Retrospective 2-center cohort study.
Patients: The study included 104 consecutive patients with superficial pharyngeal cancer.
Intervention: TOPER with the patients under general anesthesia.
Main Outcome Measurements: Safety of the procedure, long-term survival, clinical outcome.
Results: A total of 148 consecutive lesions were resected in 104 patients. There was no severe adverse event. Temporary tracheostomy was required in 17 patients (16%) to prevent airway obstruction. The median fasting period and hospital stay after TOPER were 2 days (range 1-20 days) and 8 days (range 3-58 days), respectively. Ninety-six patients (92%) had no local recurrence or distant metastases. Local recurrence at the primary site developed in 6 patients, but all were resolved by repeat TOPER. With a median follow-up period of 43 months (range 3-96 months), the overall survival rate at 5 years was 71% (95% CI, 59-82). Cause-specific survival rate at 5 years was 97% (95% CI, 93-100). The cumulative development rate of multiple cancers in pharyngeal mucosal sites at 5 years was 22% (95% CI, 12-33). The pharynx was preserved in all patients, and they experienced no loss of function.
Limitation: Retrospective design.
Conclusions: Peroral endoscopic resection of superficial pharyngeal cancer is a feasible and effective treatment with curative intent.
(Copyright © 2011 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.)
Databáze: MEDLINE
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