Extent of thyroidectomy and paratracheal lymph node dissection in total pharyngolaryngectomy for pyriform sinus cancer, and recurrence, survival, and postoperative hypoparathyroidism: A multicenter retrospective study

Yosuke Ariizumi; Nobuhiro Hanai; Takahiro Asakage; Akira Seto; Toshifumi Tomioka; Junji Miyabe; Hisashi Kessoku; Takashi Mukaigawa; Go Omura; Masanori Teshima; Daisuke Nishikawa; Yuki Saito; Yukinori Asada; Takuo Fujisawa; Takuma Makino; Hiroshi Nishino; Daisuke Sano; Mitsuhiko Nakahira; Kunihiko Tokashiki; Hirokazu Uemura; Tsutomu Ueda; Akihiro Sakai; Muneyuki Masuda; Takahiro Tsujikawa; Yusuke Hiei; Naoki Nishio; Hidetoshi Matsui; Naomi Kiyota; Akihiro Homma

doi:10.1002/hed.27572

Extent of thyroidectomy and paratracheal lymph node dissection in total pharyngolaryngectomy for pyriform sinus cancer, and recurrence, survival, and postoperative hypoparathyroidism: A multicenter retrospective study

Head Neck. 2024 Feb;46(2):269-281. doi: 10.1002/hed.27572. Epub 2023 Nov 13.

Authors

Yosuke Ariizumi¹, Nobuhiro Hanai², Takahiro Asakage¹, Akira Seto³, Toshifumi Tomioka⁴, Junji Miyabe⁵, Hisashi Kessoku⁶, Takashi Mukaigawa⁷, Go Omura⁸, Masanori Teshima⁹, Daisuke Nishikawa², Yuki Saito¹⁰, Yukinori Asada¹¹, Takuo Fujisawa¹², Takuma Makino¹³, Hiroshi Nishino¹⁴, Daisuke Sano¹⁵, Mitsuhiko Nakahira¹⁶, Kunihiko Tokashiki¹⁷, Hirokazu Uemura¹⁸, Tsutomu Ueda¹⁹, Akihiro Sakai²⁰, Muneyuki Masuda²¹, Takahiro Tsujikawa²², Yusuke Hiei²³, Naoki Nishio²⁴, Hidetoshi Matsui²⁵, Naomi Kiyota²⁶, Akihiro Homma²⁷

Affiliations

¹ Department of Head and Neck Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
² Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
³ Division of Head and Neck, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.
⁴ Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan.
⁵ Department of Head and Neck Surgery, Osaka International Cancer Institute, Osaka, Japan.
⁶ Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan.
⁷ Division of Head and Neck Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
⁸ Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo, Japan.
⁹ Department of Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
¹⁰ Department of Otolaryngology - Head and Neck Surgery, University of Tokyo, Tokyo, Japan.
¹¹ Department of Head and Neck Surgery, Miyagi Cancer Center, Natori, Japan.
¹² Department of Otorhinolaryngology - Head and Neck Surgery, Kansai Medical University, Osaka, Japan.
¹³ Department of Otolaryngology - Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
¹⁴ Otolaryngology Head and Neck Surgery, Jichi Medical University, Shimotsuke City, Japan.
¹⁵ Department of Otorhinolaryngology - Head and Neck Surgery, Yokohama City University School of Medicine, Yokohama, Japan.
¹⁶ Department of Head Neck Surgery, Saitama Medical University International Medical Cancer, Saitama, Japan.
¹⁷ Department of Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan.
¹⁸ Department of Otolaryngology - Head and Neck Surgery, Nara Medical University, Kashihara, Japan.
¹⁹ Department of Otorhinolaryngology - Head and Neck Surgery, Hiroshima University Hospital, Hiroshima, Japan.
²⁰ Department of Otolaryngology - Head and Neck Surgery, Tokai University, Isehara, Japan.
²¹ Department of Head and Neck Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.
²² Department of Otolaryngology - Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
²³ Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Fujita Health University, Toyoake, Japan.
²⁴ Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
²⁵ Department of Head and Neck Surgery, Hyogo Cancer Center, Akashi, Japan.
²⁶ Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Japan.
²⁷ Department of Otolaryngology - Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.

PMID: 37955187
DOI: 10.1002/hed.27572

Abstract

Background: Total pharyngolaryngectomy (TPL) is standard treatment for hypopharyngeal cancer. However, extensive thyroidectomy and paratracheal nodal dissection (PTND) can cause hypoparathyroidism. We sought to determine the optimum extent of resection.

Methods: We analyzed the clinicopathological information of 161 pyriform sinus cancer patients undergoing TPL from 25 Japanese institutions. Rates of recurrence and risk factors for hypoparathyroidism, as well as incidence of pathological contralateral level VI nodal metastasis and stomal recurrence, were investigated.

Results: The extent of thyroidectomy and nodal dissection were not independent risk factors for recurrence. Incidences of contralateral level VI nodal involvement and stomal recurrence were 1.8% and 1.2%, respectively. Patients undergoing hemithyroidectomy/ipsilateral PTND did not develop stomal recurrence and had the lowest incidence of hypoparathyroidism. Prognosis in patients without tracheostomy prior to hemithyroidectomy/ipsilateral PTND was comparable to that with more extensive resections.

Conclusions: Hemithyroidectomy/ipsilateral PTND may be sufficient for pyriform sinus cancer cases without tracheostomy.

Keywords: hypoparathyroidism; hypopharyngeal cancer; pharyngolaryngectomy; pyriform sinus; recurrence.

Publication types

Multicenter Study

MeSH terms

Humans
Hypoparathyroidism* / etiology
Hypopharyngeal Neoplasms* / pathology
Hypopharyngeal Neoplasms* / surgery
Lymph Node Excision / adverse effects
Neck Dissection
Pyriform Sinus* / pathology
Pyriform Sinus* / surgery
Retrospective Studies
Thyroid Neoplasms* / pathology
Thyroid Neoplasms* / surgery
Thyroidectomy / adverse effects

Abstract

Publication types

MeSH terms

Grants and funding