Clinical outcome of endoscopic-assisted transoral surgery for superficial cancer of pharyngo-esophageal junction

Head Neck. 2023 Aug;45(8):2098-2107. doi: 10.1002/hed.27439. Epub 2023 Jun 23.

Abstract

Background: Endoscopic-assisted transoral surgery (TOS) for superficial cancer of the pharyngo-esophageal junction (PEJ) is risk of stricture, and therapeutic outcomes are unclear. This study aimed to evaluate clinical outcomes of endoscopic-assisted TOS for superficial PEJ cancers.

Methods: We retrospectively compared clinical outcomes of endoscopic-assisted TOS for superficial PEJ cancers (group A) and of other sites in the hypopharynx (group B).

Results: The group A comprised 12 lesions in 12 patients, and group B comprised 198 lesions in 146 patients. Group A and group B exhibited en bloc resection rates of 100% and 99%. Median operative times were 82 and 37 min (p < 0.001). The frequency of stricture and local recurrence in group A was significantly higher in group B (42% vs. 1%, p < 0.001; 25% vs. 6%, p = 0.036). All adverse events could be managed with conservative treatments.

Conclusions: Endoscopic-assisted TOS is not ideal for treating superficial PEJ cancers compared to other sites.

Keywords: endoscopic laryngopharyngeal surgery; endoscopic submucosal dissection; hypopharyngeal cancer; pharyngo-esophageal junction; transoral surgery.

MeSH terms

  • Constriction, Pathologic
  • Endoscopy*
  • Esophageal Neoplasms* / pathology
  • Esophageal Neoplasms* / surgery
  • Humans
  • Retrospective Studies
  • Treatment Outcome