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

• Published in: Gastrointestinal endoscopy Vol. 74; no. 3; pp. 477 - 484
• Main Authors: Muto, Manabu, MD, PhD, Satake, Hironaga, MD, Yano, Tomonori, MD, Minashi, Keiko, MD, Hayashi, Ryuichi, MD, Fujii, Satoshi, MD, PhD, Ochiai, Atsushi, MD, PhD, Ohtsu, Atsushi, MD, PhD, Morita, Shuko, MD, Horimatsu, Takahiro, MD, Ezoe, Yasumasa, MD, Miyamoto, Shinichi, MD, PhD, Asato, Ryo, MD, PhD, Tateya, Ichiro, MD, PhD, Yoshizawa, Akihiko, MD, PhD, Chiba, Tsutomu, MD, PhD
• Format: Journal Article
• Language: English
• Published: Maryland heights, MO Mosby, Inc 01-09-2011; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Carcinoma in Situ - pathology; Carcinoma in Situ - surgery; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - surgery; Digestive system. Abdomen; Endoscopy; Endoscopy, Gastrointestinal; Fasting; Female; Follow-Up Studies; Gastroenterology and Hepatology; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Investigative techniques, diagnostic techniques (general aspects); Kaplan-Meier Estimate; Length of Stay; Male; Medical sciences; Middle Aged; Neoplasm Recurrence, Local - surgery; Organ Sparing Treatments; Otorhinolaryngology. Stomatology; Pharyngeal Neoplasms - pathology; Pharyngeal Neoplasms - surgery; Reoperation; Retrospective Studies; Time Factors; Tumors; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology; EMR-C; NBI; TOPER; transoral organ-preserving pharyngeal endoscopic resection; ESD; narrow-band imaging; endoscopic submucosal dissection; EMR with a cap; Endoscopic surgery; Prognosis; Treatment; ENT disease; Pharynx disease; Malignant tumor; Pharynx cancer; Long term; Pharynx; Cancer; Organ
• ISSN: 0016-5107; 1097-6779
• DOI: 10.1016/j.gie.2011.04.027

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.