title: Clinical features of pharyngeal intraepithelial neoplasias and outcomes of treatment by endoscopic submucosal dissection.
abstract: BACKGROUND
  Endoscopic detection of superficial squamous epithelial lesions of the pharynx has increased.
  
  
  OBJECTIVE
  To clarify the association between macroscopic and histologic characteristics of intraepithelial pharyngeal neoplasias, and to evaluate the effectiveness of endoscopic submucosal dissection (ESD) for their treatment.
  
  
  METHODS
  Retrospective analysis of the features of high-grade dysplasia or carcinoma in situ (HGD/CIS) versus low-grade dysplasia (LGD) and of ESD-based outcomes.
  
  
  METHODS
  Endoscopy department at a university hospital.
  
  
  METHODS
  Fifty-one patients with 66 lesions treated by ESD from November 2007 to March 2011.
  
  
  RESULTS
  Primary hypopharyngeal lesions were significantly more frequent in HGD/CIS than in LGD (54.1% vs 20.7%, P = .011), and oropharyngeal lesions were significantly less frequent in HGD/CIS (45.9% vs 79.3%, P = .011). HGD/CIS lesions were significantly larger than LGD lesions (median 8 mm vs 4 mm, P < .01). Morphologically, type 0-IIa was significantly more frequent in HGD/CIS lesions than in LGD lesions (37.8% vs 3.4%, P < .001), and type 0-IIb was significantly less frequent in HGD/CIS lesions (59.5% vs 96.6%, P < .001). The type IV intraepithelial papillary capillary loop pattern was significantly less frequent in HGD/CIS lesions than in LGD lesions (27.0% vs 55.2%, P = .025), and type V-2 was significantly more frequent in HGD/CIS lesions (18.9% vs 0%, P = .015). The en bloc resection rate was 97%. No serious complications occurred. There were no recurrent or metachronous tumors in the 41 patients followed for more than 1 year (median follow-up 27 months).
  
  
  CONCLUSIONS
  Retrospective design and single-center study.
  
  
  CONCLUSIONS
  HGD/CIS and LGD differ in various clinical features. ESD appears to be an effective treatment for pharyngeal intraepithelial neoplasias.
authors.affiliation: Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Takayasu
authors.initials: T
authors.lastname: Kuwabara
authors.forename: Toru
authors.initials: T
authors.lastname: Hiyama
authors.forename: Shiro
authors.initials: S
authors.lastname: Oka
authors.forename: Yuji
authors.initials: Y
authors.lastname: Urabe
authors.forename: Shinji
authors.initials: S
authors.lastname: Tanaka
authors.forename: Masaharu
authors.initials: M
authors.lastname: Yoshihara
authors.forename: Koji
authors.initials: K
authors.lastname: Arihiro
authors.forename: Fumio
authors.initials: F
authors.lastname: Shimamoto
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002278:Carcinoma in Situ / Q000473:pathology / Q000601:surgery; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010610:Pharyngeal Neoplasms / Q000473:pathology / Q000601:surgery; D010611:Pharyngectomy / Q000379:methods*; D020545:Respiratory Mucosa / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome