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

被引:0
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作者
Ushiro, Koji [1 ]
Watanabe, Yoshiki [2 ]
Kishimoto, Yo [3 ]
Kawai, Yoshitaka [3 ]
Fujimura, Shintaro [3 ]
Asato, Ryo [1 ]
Tsujimura, Takashi [4 ]
Hori, Ryusuke [5 ,6 ,7 ]
Kumabe, Yohei [8 ]
Yasuda, Kaori [4 ,8 ]
Tamaki, Hisanobu [9 ]
Iki, Takehiro [9 ]
Kitani, Yoshiharu [10 ]
Kurata, Keisuke [10 ]
Kojima, Tsuyoshi [3 ,7 ]
Takata, Kuniaki [7 ]
Kada, Shinpei [11 ]
Takebayashi, Shinji [12 ]
Shinohara, Shogo [13 ]
Hamaguchi, Kiyomi [3 ,13 ]
Miyazaki, Masakazu [14 ]
Ikenaga, Tadashi [14 ]
Maetani, Toshiki [15 ]
Harada, Hiroyuki [15 ]
Haji, Tomoyuki [9 ]
Omori, Koichi [3 ]
机构
[1] Natl Hosp Org, Dept Otolaryngol Head & Neck Surg, Kyoto Med Ctr, 1-1 Mukaihata Cho,Fushimi Ku, Fukakusa, Kyoto 6128555, Japan
[2] Japanese Red Cross Osaka Hosp, Dept Otolaryngol Head & Neck Surg, Osaka, Japan
[3] Kyoto Univ, Grad Sch Med, Dept Otolaryngol Head & Neck Surg, Kyoto, Japan
[4] Japanese Red Cross, Wakayama Med Ctr, Wakayama, Japan
[5] Univ Occupat & Environm Hlth, Dept Otolaryngol Head & Neck Surg, Kitakyushu, Fukuoka, Japan
[6] Fujita Hlth Univ, Dept Otolaryngol Head & Neck Surg, Toyoake, Aichi, Japan
[7] Tenri Hosp, Dept Otolaryngol Head & Neck Surg, Tenri, Nara, Japan
[8] Hyogo Prefectural Amagasaki Gen Med Ctr, Dept Otolaryngol Head & Neck Surg, Amagasaki, Hyogo, Japan
[9] Kurashiki Cent Hosp, Dept Otolaryngol Head & Neck Surg, Kurashiki, Okayama, Japan
[10] Shizuoka Prefectural Gen Hosp, Dept Otolaryngol Head & Neck Surg, Shizuoka, Japan
[11] Japanese Red Cross Otsu Hosp, Dept Otolaryngol Head & Neck Surg, Otsu, Shiga, Japan
[12] Shiga Gen Hosp, Dept Otolaryngol Head & Neck Surg, Moriyama, Japan
[13] Kobe City Med Ctr Gen Hosp, Dept Otolaryngol Head & Neck Surg, Kobe, Hyogo, Japan
[14] Nara Prefecture Gen Med Ctr, Dept Otolaryngol Head & Neck Surg, Nara, Japan
[15] Kitano Hosp, Med Res Inst, Dept Otolaryngol Head & Neck Surg, Osaka, Japan
关键词
Transoral surgery; Hypopharyngeal cancer; Minimally invasive treatment; Neck dissection; Adjuvant therapy; Multi-institutional retrospective study; ROBOTIC SURGERY; LASER MICROSURGERY; FUNCTIONAL OUTCOMES; CANCER; FEASIBILITY; RESECTION; LARYNX; HEAD;
D O I
10.1016/j.anl.2024.10.004
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
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.
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收藏
页码:956 / 963
页数:8
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