title: Feasibility of a "resect and watch" strategy with endoscopic resection for superficial pharyngeal cancer.
abstract: BACKGROUND
  After endoscopic resection (ER) for superficial pharyngeal cancer (SPC), additional treatments such as radical surgical resection or radiation therapy may be needed in cases of possible incomplete resection. However, the benefit of prophylactic additional treatment is unclear.
  
  
  OBJECTIVE
  To evaluate the feasibility of a "resect and watch" strategy with ER for SPC.
  
  
  METHODS
  Retrospective, single-center cohort study.
  
  
  METHODS
  Tertiary cancer center.
  
  
  METHODS
  A total of 32 patients with 47 SPCs were eligible.
  
  
  METHODS
  A "resect and watch" strategy of initial ER and observation until development of secondary diseases, including local recurrence, neck lymph node metastasis (LNM), and metachronous pharyngeal cancer.
  
  
  METHODS
  Complications, tumor recurrence, development of metachronous pharyngeal cancer, overall survival, and cause-specific survival.
  
  
  RESULTS
  There were no severe complications related to ER. Median length of follow-up was 43 months (range, 7-76 months). Cumulative development of secondary diseases at 5 years was 44% (95% CI, 24.5%-63.8%). Local recurrence (N = 4) and neck LNM (N = 5) were successfully treated by local resection (2 partial surgical resections and 2 additional ERs) and neck dissection, respectively. Metachronous pharyngeal cancers (N = 6) were completely removed by ER. The overall survival and cause-specific survival rates at 5 years were 84.4% (95% CI, 70.0%-98.8%) and 100%, respectively. No patient needed radical surgery as an additional therapy. Thus, the larynx and its function were preserved in all patients.
  
  
  CONCLUSIONS
  Retrospective nature, single-center setting, relatively small sample size.
  
  
  CONCLUSIONS
  A "resect and watch" strategy with ER for SPC is feasible and rational.
authors.affiliation: Division of Endoscopy, Shizuoka Cancer Center, Nagaizumi, Suntogun, Shizuoka, Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Imai
authors.forename: Masaki
authors.initials: M
authors.lastname: Tanaka
authors.forename: Noriaki
authors.initials: N
authors.lastname: Hasuike
authors.forename: Naomi
authors.initials: N
authors.lastname: Kakushima
authors.forename: Kohei
authors.initials: K
authors.lastname: Takizawa
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Matsubayashi
authors.forename: Kinichi
authors.initials: K
authors.lastname: Hotta
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Yamaguchi
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Onitsuka
authors.forename: Kimihide
authors.initials: K
authors.lastname: Kusafuka
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ono
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002173:Cancer Care Facilities; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D002423:Cause of Death; D015331:Cohort Studies; D018572:Disease-Free Survival; D004724:Endoscopy / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D007828:Laryngoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology; D009367:Neoplasm Staging; D010610:Pharyngeal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D016019:Survival Analysis; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D057832:Watchful Waiting