Endoscopic submucosal dissection for treatment of early stage hypopharyngeal carcinoma.
BACKGROUND
Early detection of hypopharyngeal carcinoma is increasingly possible and patients with such early lesions can be treated with endoscopic resection.


OBJECTIVE
To identify the optimal relationship between the mucosal defect of the hypopharynx and malfunction of the hypopharynx after endoscopic resection of early hypopharyngeal carcinoma.


METHODS
Case series.


METHODS
Referral center in Japan.


METHODS
Four patients with early-stage squamous cell carcinoma of the hypopharynx underwent endoscopic submucosal dissection (ESD). By using ESD, an accurate incision line close to the tumor margin could be confirmed while performing treatment. ESD was performed with a small-caliber-tip transparent hood (ST-hood) to open the incision line for better visualization of the submucosa.


METHODS
Feasibility of en bloc resection, complications, and recurrence after ESD.


RESULTS
No early or late complications due to treatment occurred in the patients. Histological examination of resected specimens revealed that 2 patients had carcinoma in situ and 2 patients had tumor invasion of the subepithelium. There was no local recurrence or distant metastasis in any of the patients during the follow-up period (3-14 months).


CONCLUSIONS
We consider that ESD is the optimal method for endoscopic resection not only because it enables an en bloc resected specimen to be obtained but also because it can prevent removal of excess mucosa of the hypopharynx, which is a very narrow and important organ related to swallowing and speech.
Shimizu
Yuichi
Y
Division of Endoscopy and Department of Otolaryngology, Hokkaido University Hospital, Sapporo, Japan.
Yamamoto
Junji
J
Kato
Mototsugu
M
Yoshida
Takeshi
T
Hirota
Jojo
J
Ono
Yuji
Y
Nakagawa
Manabu
M
Nakagawa
Souichi
S
Oridate
Nobuhiko
N
Asaka
Masahiro
M
D000368:Aged; D000768:Anesthesia, General; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D003131:Combined Modality Therapy; D004210:Dissection / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000601:surgery; D009367:Neoplasm Staging