A multicenter retrospective study on neck dissection and adjuvant radiotherapy with transoral surgery for hypopharyngeal squamous cell carcinoma.

Autor: Ushiro K; Department of Otolaryngology - Head & Neck Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan. Electronic address: k_ushiro@ent.kuhp.kyoto-u.ac.jp., Watanabe Y; Department of Otolaryngology - Head & Neck Surgery, Japanese Red Cross Osaka Hospital, Osaka, Japan., Kishimoto Y; Department of Otolaryngology - Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan., Kawai Y; Department of Otolaryngology - Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan., Fujimura S; Department of Otolaryngology - Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan., Asato R; Department of Otolaryngology - Head & Neck Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan., Tsujimura T; Department of Otolaryngology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan., Hori R; 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., Kumabe Y; Department of Otolaryngology - Head & Neck Surgery, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan., Yasuda K; Department of Otolaryngology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan; Department of Otolaryngology - Head & Neck Surgery, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan., Tamaki H; Department of Otolaryngology - Head & Neck Surgery, Kurashiki Central Hospital, Kurashiki, Japan., Iki T; Department of Otolaryngology - Head & Neck Surgery, Kurashiki Central Hospital, Kurashiki, Japan., Kitani Y; Department of Otolaryngology - Head & Neck Surgery, Shizuoka General Hospital, Shizuoka, Japan., Kurata K; Department of Otolaryngology - Head & Neck Surgery, Shizuoka General Hospital, Shizuoka, Japan., Kojima T; Department of Otolaryngology - Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan; Department of Otolaryngology - Head & Neck Surgery, Tenri Hospital, Tenri, Japan., Takata K; Department of Otolaryngology - Head & Neck Surgery, Tenri Hospital, Tenri, Japan., Kada S; Department of Otolaryngology - Head & Neck Surgery, Japanese Red Cross Otsu Hospital, Otsu, Japan., Takebayashi S; Department of Otolaryngology - Head & Neck Surgery, Shiga General Hospital, Moriyama, Japan., Shinohara S; Department of Otolaryngology - Head & Neck Surgery, Kobe City Medical Center General Hospital, Kobe, Japan., Hamaguchi K; 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., Miyazaki M; Department of Otolaryngology - Head & Neck Surgery, Nara Prefecture General Medical Center, Nara, Japan., Ikenaga T; Department of Otolaryngology - Head & Neck Surgery, Nara Prefecture General Medical Center, Nara, Japan., Maetani T; Department of Otolaryngology - Head & Neck Surgery, Medical Research Institute, Kitano Hospital, Osaka, Japan., Harada H; Department of Otolaryngology - Head & Neck Surgery, Medical Research Institute, Kitano Hospital, Osaka, Japan., Haji T; Department of Otolaryngology - Head & Neck Surgery, Kurashiki Central Hospital, Kurashiki, Japan., Omori K; Department of Otolaryngology - Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Jazyk: angličtina
Zdroj: Auris, nasus, larynx [Auris Nasus Larynx] 2024 Oct 09; Vol. 51 (6), pp. 956-963. Date of Electronic Publication: 2024 Oct 09.
DOI: 10.1016/j.anl.2024.10.004
Abstrakt: Objective: The aim of this multicenter retrospective study was to analyze the impact of prophylactic neck dissection and adjuvant therapy in transoral surgery for hypopharyngeal cancer.
Methods: We compared the impact of surgical margin assessment, neck dissection, and adjuvant treatment on oncologic outcomes in patients who underwent transoral surgery for hypopharyngeal squamous cell carcinoma between 2015 and 2021.
Results: Two hundred and twenty-one patients were included. The 3-year local recurrence-free survival was 89.1 %, and local recurrence did not significantly impact overall survival. Positive vertical margins resulted in 60 % of patients receiving additional treatment, with no increase in local recurrence and a significant increase in regional recurrence (p = 0.007) and distant metastasis (p < 0.001). Half of the patients with regional recurrence after neck dissection also had distant metastases and worse survival (p = 0.069), while those with regional recurrence without prophylactic neck dissection did not have worse survival.
Conclusion: In cases of positive vertical margin, careful surveillance for regional recurrence and distant metastasis is also warranted. Prophylactic neck dissection may not be necessary.
Competing Interests: Declaration of competing interest The authors have no funding, financial relationship, or conflicts of interest to disclose.
(Copyright © 2024. Published by Elsevier B.V.)
Databáze: MEDLINE
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