Transoral surgery for superficial head and neck cancer: National Multi‐Center Survey in Japan

Katada, Chikatoshi; Muto, Manabu; Fujii, Satoshi; Yokoyama, Tetsuji; Yano, Tomonori; Watanabe, Akihito; Iizuka, Toshiro; Yoshinaga, Shigetaka; Tateya, Ichiro; Mitani, Hiroki; Shimizu, Yuichi; Takahashi, Akiko; Kamijo, Tomoyuki; Hanaoka, Noboru; Abe, Makoto; Shiotani, Akiko; Kano, Koichi; Asada, Yukinori; Matsuhashi, Tamotsu; Umeno, Hirohito; Okami, Kenji; Goda, Kenichi; Hori, Shinichiro; Ono, Yoshiyuki; Terai, Shuji; Nagami, Yasuaki; Takemura, Kenichi; Kawada, Kenro; Ando, Mizuo; Shimeno, Naoto; Arai, Akihito; Sakamoto, Yasutoshi; Ichinoe, Masaaki; Nemoto, Tetsuo; Fujita, Masahiro; Watanabe, Hidenobu; Shimoda, Tadakazu; Ochiai, Atsushi; Kato, Takakuni; Hayashi, Ryuichi

doi:10.1002/cam4.3927

Cited by 9 publications

(8 citation statements)

References 31 publications

(31 reference statements)

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“…ESD of lesions located on the posterior walls of the oropharynx and hypopharynx is challenging because of the shallow subepithelial layers. The median procedure time for pharyngeal ESD is 50-124.9 min [11][12][13]. To overcome this technical difficulty, several mechanical traction techniques, including the use of laryngeal forceps, clip and thread technique, ring-shaped thread traction, and the grasping forceps method, have been reported [26][27][28].…”

Section: Discussionmentioning

confidence: 99%

“…Recent developments in narrowband imaging (NBI) [5] and the establishment of a precise pharyngeal observation method [6] have enabled increased early-stage detection of superficial pharyngeal cancers. Early-stage pharyngeal cancers can be cured via transoral surgery (TOS), which preserves organ function and quality of life of the patient, and is an effective minimally invasive treatment [7][8][9][10][11][12][13]. TOS includes transoral video-assisted surgery, endoscopic laryngopharyngeal surgery, and endoscopic resection.…”

Section: Introductionmentioning

confidence: 99%

“…The primary clinical advantage of TOS is that it protects patients who are candidates for organ-and function-sparing procedures from the potentially adverse events (AEs0 of radical surgery or chemoradiation. En bloc resection rates using endoscopic submucosal dissection (ESD) for pharyngeal cancer are high (77.4%-100%) in TOS [7,8,11,12,13]. The fasting period for ESD is typically 2 days.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and safety of the water pressure method for endoscopic submucosal dissection in superficial pharyngeal cancer

Matsuura,

Kato,

Iwata

et al. 2024

Endosc Int Open

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Background: Superficial pharyngeal cancers can be cured with transoral surgery (TOS), which preserves organ function and quality of life. Pharyngeal endoscopic submucosal dissection (ESD) is challenging to perform because of limited manoeuvrability and complex anatomical features. The water pressure method (WPM) is useful for natural traction techniques during ESD, and is potentially useful for pharyngeal ESD. This study aimed to investigate the short-term outcomes of WPM-ESD for pharyngeal lesions. Patients and Methods: Therapeutic outcomes of patients who underwent WPM-ESD for pharyngeal lesions at Keio University between May 2019 and February 2022 were retrospectively analysed. Results: Twenty-one pharyngeal lesions treated with WPM-ESD were analysed. Three lesions were located in the oropharynx and 18 in the hypopharynx. All ESD procedures were performed under general anaesthesia. The endoscopic en bloc resection rate was 100%. The median procedure time was 15 min (range 4–45 min). All patients were successfully extubated on the day of ESD. No serious adverse events related to WPM-ESDs were observed. None of the patients required nasogastric intubation, percutaneous endoscopic gastrostomy, or tracheotomy. The median fasting time and hospital stay were 2 d (range 2–5 d) and 6 d (range 6–10 d), respectively. All the histological results indicated squamous cell carcinoma. The complete histologic resection rate was 76.2%. Conclusions: WPM-ESD achieved a high en bloc resection rate and short procedure time without serious adverse events. Thus, WPM-ESD may be a useful treatment for pharyngeal lesions.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy and safety of the water pressure method for endoscopic submucosal dissection in superficial pharyngeal cancer

Matsuura,

Kato,

Iwata

et al. 2024

Endosc Int Open

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“…TOS has been reported to be effective and safe. [10][11][12] Endoscopy of the pharyngeal region is difficult to perform sufficiently and consistently because of its aforementioned anatomical or functional characteristics. In fact, when endoscopy is performed under general anesthesia (GA) during TOS, multiple synchronous lesions that were undetectable using preoperative endoscopy can be observed using white light endoscopy (WLE) or NBI.…”

Section: Detailed Endoscopic Observation Of the Pharyngeal Region Ismentioning

confidence: 99%

Efficacy of endoscopy under general anesthesia for the detection of synchronous lesions in oro-hypopharyngeal cancer

Ono

Yao

Takaki³

et al. 2023

Clin Endosc

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Background/Aims: Image-enhanced endoscopy can detect superficial oro-hypopharyngeal squamous cell carcinoma; however, reliable endoscopy of the pharyngeal region is challenging. Endoscopy under general anesthesia during transoral surgery occasionally reveals multiple synchronous lesions that remained undetected on preoperative endoscopy. Therefore, we aimed to determine the lesion detection capability of endoscopy under general anesthesia for superficial oro-hypopharyngeal squamous cell carcinoma. Methods: This retrospective study included 63 patients who underwent transoral surgery for superficial oropharyngeal squamous cell carcinoma between April 2005 and December 2020. The primary endpoint was to compare the lesion detection capabilities of preoperative endoscopy and endoscopy under general anesthesia. Other endpoints included the comparison of clinicopathological findings between lesions detected using preoperative endoscopy and those newly detected using endoscopy under general anesthesia. Results: Fifty-eight patients (85 lesions) were analyzed. The mean number of lesions per patient detected was 1.17 for preoperative endoscopy and 1.47 for endoscopy under general anesthesia. Endoscopy under general anesthesia helped detect more lesions than preoperative endoscopy did (p<0.001, paired t-test). The lesions that were newly detected on endoscopy under general anesthesia were small and characterized by few changes in color and surface ruggedness. Conclusions: Endoscopy under general anesthesia for superficial squamous cell carcinoma is helpful for detecting multiple synchronous lesions.

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“…Surprisingly, 25 patients (26.0%) died of metachronous cancer arising in other organs. Specific sites of cancer among those 25 patients were esophageal cancer in 8 patients, lung cancer in six patients, colorectal cancer in three patients, gastric cancer in two patients, liver cancer in two patients, bile duct cancer in two patients, duodenal cancer in one patient, and ureteral cancer in one patient 46 . To improve the outcome of ER for superficial head and neck SCC, it is necessary to detect metachronous cancers arising in other organs at an early stage when they can be effectively treated.…”

Section: Unresolved Issues and Future Perspectivesmentioning

confidence: 99%

Alcohol consumption, multiple Lugol‐voiding lesions, and field cancerization

et al. 2023

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The development of multiple squamous cell carcinomas (SCC) in the upper aerodigestive tract, which includes the oral cavity, pharynx, larynx, and esophagus, is explained by field cancerization and is associated with alcohol consumption and cigarette smoking. We reviewed the association between alcohol consumption, multiple Lugol‐voiding lesions, and field cancerization, mainly based on the Japan Esophageal Cohort study. The Japan Esophageal Cohort study is a prospective cohort study that enrolled patients with esophageal SCC after endoscopic resection. Enrolled patients received surveillance by gastrointestinal endoscopy every 6 months and surveillance by an otolaryngologist every 12 months. The Japan Esophageal Cohort study showed that esophageal SCC and head and neck SCC that developed after endoscopic resection for esophageal SCC were associated with genetic polymorphisms related to alcohol metabolism. They were also associated with Lugol‐voiding lesions grade in the background esophageal mucosa, the score of the health risk appraisal model for predicting the risk of esophageal SCC, macrocytosis, and score on alcohol use disorders identification test. The standardized incidence ratio of head and neck SCC in patients with esophageal SCC after endoscopic resection was extremely high compared to the general population. Drinking and smoking cessation is strongly recommended to reduce the risk of metachronous esophageal SCC after treatment of esophageal SCC. Risk factors for field cancerization provide opportunities for early diagnosis and minimally invasive treatment. Lifestyle guidance of alcohol consumption and cigarette smoking for esophageal precancerous conditions, which are endoscopically visualized as multiple Lugol‐voiding lesions, may play a pivotal role in decreasing the incidence and mortality of esophageal SCC.

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Transoral surgery for superficial head and neck cancer: National Multi‐Center Survey in Japan

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 9 publications

References 31 publications

Efficacy and safety of the water pressure method for endoscopic submucosal dissection in superficial pharyngeal cancer

Efficacy and safety of the water pressure method for endoscopic submucosal dissection in superficial pharyngeal cancer

Efficacy of endoscopy under general anesthesia for the detection of synchronous lesions in oro-hypopharyngeal cancer

Alcohol consumption, multiple Lugol‐voiding lesions, and field cancerization

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