Pharyngotomy in head and neck squamous cell carcinoma: functional and oncological aspects

Abstract

Background: Head and Neck Surgery constantly has to oppose non-invasive organ preservation methods and therefore should be evaluated especially with regard to clinical and functional outcome. We will discuss the role of pharyngotomy in the treatment of HNSCC.

Methods: Seventy-three patients with carcinoma of the oral cavity, oro-/hypopharynx and supraglottis underwent lateral/median pharyngotomy. Functional and oncological parameters were retrospectively assessed and set into clinical context.

Results: The 5-year recurrence-free-interval (RFI) was significantly higher with surgery and adjuvant radio(chemo)therapy (80%; mean RFI: 92 months) when compared to conservative treatment (68%; mean RFI: 68 months). The 5-year overall-survival (OS) after surgery and conservative treatment was 71% and 54%, respectively. Compared to other surgical techniques (mean RFI: 82 months), pharyngotomy demonstrated a significant higher 5-year RFI (mean RFI: 89 months).

Conclusions: Pharyngotomy achieves good exposure and clear resection margins that result in a notably good oncological outcome with a minimum of functional loss. In particular, among UICC IV oropharyngeal HNSCC, pharyngotomy is superior in OS and RFI to conservative methods.

Chinese abstract

背景：头颈外科手术不断反对保守性保器官方法, 因此特别应该评估其临床和功能结果。我们将讨论咽部切开术在HNSCC治疗中的作用。

方法：73例口腔癌、口咽癌和咽上腺癌患者接受了侧/中位切开术。回顾性评估功能和肿瘤学参数, 并将其置于临床环境中。

结果：与保守治疗（68％;平均RFI：68个月）相比, 手术和辅助放疗（化疗）治疗（80％;平均RFI：92个月）的5年无复发期（RFI）高很多。手术后5年总生存期（OS）和保守治疗分别为71％和54％。与其它手术（平均RFI：82个月）相比, 咽切除术显示出高得多的5年RFI（平均RFI：89个月）。

结论：咽部切开术取得良好的暴露和清晰的切除缘, 导致明显良好的肿瘤学结果, 功能损失最小。特别是在UICC IV口咽HNSCC中, 咽部切除术在OS和RFI方面优于保守疗法。

Keywords:

• Pharyngotomy
• head and neck squamous cell carcinoma
• outcome
• videofluoroscopy
• function

Disclosure statement

No potential conflict of interest was reported by the authors.