Conservation surgery for hypopharyngeal cancer: changing paradigm from open to endoscopic

Kuo, Chin‐Lung; Lee, Tsung-Lun; Chu, Pen–Yuan

doi:10.3109/00016489.2013.805341

Cited by 12 publications

(31 citation statements)

References 20 publications

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“…In the present study, there were no major complications, such as perioperative massive bleeding, pharyngocutaneous fistula formation, or airway compromise. The average hospital stay after surgery was 10.3 days, which was similar to 12 days of TLM reported by Kuo et al…”

Section: Discussionsupporting

confidence: 82%

“…Our experience of 10 cases indicates that TORS without the tracheostomy procedure can be successfully executed with en bloc resection of the early pyriform sinus tumor, as in some TLM cases. Our patients' endotracheal tubes were removed 1.2 days (average) after TORS, which was comparable to 7 days after TLM, as reported by Kuo et al However, TORS offers several advantages, such as the excellent panoramic view of the hypopharynx that ensures an en bloc cone‐shaped excision of the pyriform sinus (see Figure ) that is usually difficult in TLM. The endowristed instrument of TORS has 7 degrees of freedom that allow a precise incision and dissection at different angles/directions with motion scaling and tremor reduction function that avoids paradoxical long instrument movement in TLM.…”

Section: Discussionsupporting

confidence: 82%

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Transoral robotic surgery for early T classification hypopharyngeal cancer

Wang

Liu²,

et al. 2015

Head & Neck

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Background. For hypopharyngeal cancer, transoral robotic surgery (TORS) has been reported as a new organ preserving treatment but outcomes are rarely reported. Methods. From 2010 to 2013, 10 patients with early T classification pyriform sinus cancer were selected to receive TORS and conventional neck dissection. The clinical parameters, including rates of adjuvant radiotherapy, survivals, as well as organ and function preservation, were retrospectively analyzed. Results. TORS was successful in all 10 patients, and 5 patients received adjuvant radiotherapy. After mean follow-up of 26 months, 1 patient died of distant metastasis and 1 patient died of other malignancy. There was no local recurrence and larynxes were all preserved. Eight surviving patients who were followed up continuously could receive oral intake and had a serviceable voice without tracheostomy or feeding tubes. Conclusion. TORS is a feasible transoral approach for selected patients with early T classification hypopharyngeal cancer. The reported oncologic/functional outcomes are satisfactory.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 82%

Transoral robotic surgery for early T classification hypopharyngeal cancer

Wang

Liu²,

et al. 2015

Head & Neck

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“…The previous studies reported that the LRC rate of early-stage HPSCC was 60% to 88% when treated either by surgery [5-7] or by definitive RT [8-13]. We found that the 5-year LRC rate of these patients was 65%, which was comparable to other studies.…”

Section: Discussionsupporting

confidence: 86%

“…Among the 33 patients, LRF occurred in 13 patients: 8 had LF, 1 had RF, and 3 had combined failures. Kuo et al [7] reported 53 patients treated with either open partial laryngopharyngectomy or endoscopic laser microsurgery had a 5-year LRC of 71%. Of the 53 patients, 13 experienced failures (8 LF and 5 RF).…”

Section: Discussionmentioning

confidence: 99%

Early hypopharyngeal cancer treated with different therapeutic approaches: a single-institution cohort analysis

et al. 2016

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PurposeEarly hypopharyngeal squamous cell carcinoma (HPSCC) is a rarely diagnosed disease, for which the optimal treatment has not been defined yet. We assessed patterns of failure and outcomes in early HPSCC treated with various therapeutic approaches to identify its optimal treatment.Materials and MethodsThirty-six patients with stage I (n = 10) and II (n = 26) treated between January 1992 and March 2014 were reviewed. Patients received definitive radiotherapy (RT) (R group, n = 10), surgery only (S group, n = 19), or postoperative RT (PORT group, n = 7). All patients in both the R and PORT groups received elective bilateral neck irradiation. In the S group, 7 patients had ipsilateral and 8 had bilateral dissection, while 4 patients had no elective dissection.ResultsAt a median follow-up of 48 months, the 5-year locoregional control (LRC) rate was 65%. Six patients had local failure, 1 regional failure (RF), 3 combined locoregional failures, and 2 distant failures. There was no difference in 5-year LRC among the R, S, and PORT groups (p = 0.17). The presence with a pyriform sinus apex extension was a prognosticator related to LRC (p = 0.01) in the multivariate analysis. Patients with a bilaterally treated neck showed a trend toward a lower RF rate (p = 0.08).ConclusionThis study shows that patients with early stage HPSCC involving the pyriform sinus apex might need a tailored approach to improve LRC. Additionally, our study confirms elective neck treatment might have an efficacious role in regional control.

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“…This makes it premature to infer a causal link between GERD and HNCs in either direction, or whether a confounding factor might account for both findings. Nevertheless, smoking and alcohol are risk factors for GERD as well as for HNCs [23,24]; therefore, the association can likely be explained by the fact that those who smoke and drink have GERD as well as other risk factors associated with HNCs. The relationship between GERD and HNCs is more pronounced among men, and smoking and alcohol are more common among men than among women; therefore, these carcinogens can still be considered contributing factors [25,26].…”

Section: Discussionmentioning

confidence: 95%