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

Manabu Muto, Hironaga Satake, Tomonori Yano, Keiko Minashi, Ryuichi Hayashi, Satoshi Fujii, Atsushi Ochiai, Atsushi Ohtsu, Shuko Morita, Takahiro Horimatsu, Yasumasa Ezoe, Shinichi Miyamoto, Ryo Asato, Ichiro Tateya, Akihiko Yoshizawa, Tsutomu Chiba

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Abstract

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.

Original languageEnglish
Pages (from-to)477-484
Number of pages8
JournalGastrointestinal endoscopy
Volume74
Issue number3
DOIs
Publication statusPublished - 09-2011

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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    Muto, M., 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. (2011). Long-term outcome of transoral organ-preserving pharyngeal endoscopic resection for superficial pharyngeal cancer. Gastrointestinal endoscopy, 74(3), 477-484. https://doi.org/10.1016/j.gie.2011.04.027