title: Transoral videolaryngoscopic surgery for oropharyngeal, hypopharyngeal, and supraglottic cancer.
abstract: In this retrospective cohort study, we evaluated the oncological and functional outcomes of transoral videolaryngoscopic surgery (TOVS). Using distending laryngoscope and videolaryngoscope, wide operative field and working space could be obtained and tumor could be resected in en bloc. Sixty patients with T1, T2, and selected T3 laryngeal or pharyngeal squamous cell carcinomas (Stage I: n = 17, Stage II: n = 16, Stage III: n = 7, Stage IV: n = 20 cases) were enrolled and followed up for at least 24 months or until the patient's death. Fifty-three patients underwent initial treatment, and seven patients had recurrent cancer after chemoradiation. In principle, node-positive patients underwent a simultaneous neck dissection. Patients with multiple nodal metastases or a positive surgical margin received postoperative radiotherapy. For initial treatment, the 5-year overall survival and disease-specific survival rates were 77 and 95 %, respectively. For supraglottic and hypopharyngeal cancers, the 5-year laryngeal preservation rates were 89 and 96 %, respectively. For salvage surgery, the overall survival, disease-specific survival, and laryngeal preservation rates were 75, 75, and 80 %, respectively. The median times before patients could resume eating and swallowing a soft diet were 6 and 9 days, respectively. The patients' Functional Outcome Swallowing Scale stages were 0-2 in 93.3 % of the cases and 3 or 4 in 6.7 % of the cases. A percutaneous endoscopic gastrostomy was indicated for 1 (1.7 %) patient. Four (6.7 %) patients received transient tracheostomy. TOVS is a satisfactory and minimally invasive treatment option for laryngeal and pharyngeal cancers.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Tomifuji
authors.forename: Koji
authors.initials: K
authors.lastname: Araki
authors.forename: Taku
authors.initials: T
authors.lastname: Yamashita
authors.forename: Akihiro
authors.initials: A
authors.lastname: Shiotani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D005931:Glottis; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000601:surgery*; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D059351:Organ Sparing Treatments; D009959:Oropharyngeal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D016879:Salvage Therapy; D000077195:Squamous Cell Carcinoma of Head and Neck; D016896:Treatment Outcome; D020535:Video-Assisted Surgery / Q000379:methods*