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

IF 1.6 4区医学 Q2 OTORHINOLARYNGOLOGY Auris Nasus Larynx Pub Date : 2024-10-09 DOI:10.1016/j.anl.2024.10.004

Koji Ushiro , Yoshiki Watanabe , Yo Kishimoto , Yoshitaka Kawai , Shintaro Fujimura , Ryo Asato , Takashi Tsujimura , Ryusuke Hori , Yohei Kumabe , Kaori Yasuda , Hisanobu Tamaki , Takehiro Iki , Yoshiharu Kitani , Keisuke Kurata , Tsuyoshi Kojima , Kuniaki Takata , Shinpei Kada , Shinji Takebayashi , Shogo Shinohara , Kiyomi Hamaguchi , Koichi Omori

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Abstract

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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一项关于下咽鳞状细胞癌颈部切除术和经口手术辅助放疗的多中心回顾性研究。

研究目的这项多中心回顾性研究旨在分析经口手术治疗下咽癌中预防性颈部切除和辅助治疗的影响：我们比较了2015年至2021年间接受经口手术治疗下咽鳞状细胞癌患者的手术边缘评估、颈部切除和辅助治疗对肿瘤预后的影响：结果：共纳入 221 名患者。3年无局部复发生存率为89.1%，局部复发对总生存率无显著影响。垂直边缘阳性导致60%的患者接受额外治疗，局部复发率没有增加，区域复发率（p = 0.007）和远处转移率（p < 0.001）显著增加。颈部切除术后区域复发的患者中，半数也有远处转移，生存率更差（p = 0.069），而未进行预防性颈部切除术的区域复发患者生存率并不更差：结论：在垂直边缘阳性的病例中，也需要仔细观察区域复发和远处转移。预防性颈部切除术可能没有必要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Auris Nasus Larynx 医学-耳鼻喉科学

CiteScore

3.40

自引率

5.90%

发文量

169

审稿时长

30 days

期刊介绍： The international journal Auris Nasus Larynx provides the opportunity for rapid, carefully reviewed publications concerning the fundamental and clinical aspects of otorhinolaryngology and related fields. This includes otology, neurotology, bronchoesophagology, laryngology, rhinology, allergology, head and neck medicine and oncologic surgery, maxillofacial and plastic surgery, audiology, speech science. Original papers, short communications and original case reports can be submitted. Reviews on recent developments are invited regularly and Letters to the Editor commenting on papers or any aspect of Auris Nasus Larynx are welcomed. Founded in 1973 and previously published by the Society for Promotion of International Otorhinolaryngology, the journal is now the official English-language journal of the Oto-Rhino-Laryngological Society of Japan, Inc. The aim of its new international Editorial Board is to make Auris Nasus Larynx an international forum for high quality research and clinical sciences.