{"title":"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。","authors":"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","doi":"10.1016/j.anl.2024.10.004","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 (<em>p</em> = 0.007) and distant metastasis (<em>p</em> < 0.001). Half of the patients with regional recurrence after neck dissection also had distant metastases and worse survival (<em>p</em> = 0.069), while those with regional recurrence without prophylactic neck dissection did not have worse survival.</div></div><div><h3>Conclusion</h3><div>In cases of positive vertical margin, careful surveillance for regional recurrence and distant metastasis is also warranted. Prophylactic neck dissection may not be necessary.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"51 6","pages":"Pages 956-963"},"PeriodicalIF":1.6000,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A multicenter retrospective study on neck dissection and adjuvant radiotherapy with transoral surgery for hypopharyngeal squamous cell carcinoma\",\"authors\":\"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\",\"doi\":\"10.1016/j.anl.2024.10.004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 (<em>p</em> = 0.007) and distant metastasis (<em>p</em> < 0.001). Half of the patients with regional recurrence after neck dissection also had distant metastases and worse survival (<em>p</em> = 0.069), while those with regional recurrence without prophylactic neck dissection did not have worse survival.</div></div><div><h3>Conclusion</h3><div>In cases of positive vertical margin, careful surveillance for regional recurrence and distant metastasis is also warranted. Prophylactic neck dissection may not be necessary.</div></div>\",\"PeriodicalId\":55627,\"journal\":{\"name\":\"Auris Nasus Larynx\",\"volume\":\"51 6\",\"pages\":\"Pages 956-963\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-10-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Auris Nasus Larynx\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0385814624001238\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"OTORHINOLARYNGOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Auris Nasus Larynx","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0385814624001238","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
A multicenter retrospective study on neck dissection and adjuvant radiotherapy with transoral surgery for hypopharyngeal squamous cell carcinoma
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.
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.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
