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

Acta Otolaryngol. 2017 Dec;137(12):1281-1287. doi: 10.1080/00016489.2017.1355564. Epub 2017 Jul 25.

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.

Keywords: Pharyngotomy; function; head and neck squamous cell carcinoma; outcome; videofluoroscopy.

MeSH terms

  • Aged
  • Carcinoma, Squamous Cell / surgery*
  • Female
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Male
  • Middle Aged
  • Otorhinolaryngologic Surgical Procedures*
  • Pharynx / surgery*
  • Retrospective Studies