title: A clinical study of transoral pharyngectomies to treat superficial hypopharyngeal cancers.
abstract: BACKGROUND
  For years, it has been a major interest for surgeons and oncologists to develop a novel technique to detect hypopharyngeal cancers at an early stage and to treat the lesions in a less invasive manner. The advent of the narrow band imaging system combined endoscopy and various endoscopic approaches shed light on the new era of the minimum invasive management of superficial cancers in hypopharyngeal regions.
  
  
  METHODS
  Three endoscopic approaches, endoscopic mucosal resection, endoscopic submucosal dissection and endoscopic laryngopharyngeal surgery, were chronologically introduced at our institute. In this study, we focused on the clinical outcomes, advantages and limitations of each procedure.
  
  
  RESULTS
  A total of 30 patients (42 procedures) received transoral pharyngectomies between June 2006 and May 2012. Tracheotomy was performed in 9 of 42 (21%) patients. Three patients developed local recurrence and were subsequently controlled by additional transoral pharyngectomies. The 2- and 5-year local control rates were 92.8 and 83.5%. The 2- and 5-year overall survival rates were 82.1%.
  
  
  CONCLUSIONS
  Endoscopic mucosal resection, endoscopic submucosal dissection and endoscopic laryngopharyngeal surgery-transoral pharyngectomies are useful procedures for treating superficial hypopharyngeal cancers. Endoscopic mucosal resection manifested the least invasiveness and may be beneficial for resecting small superficial lesions, endoscopic submucosal dissection may be advantageous for patients with difficult laryngopharyngeal exposure and endoscopic laryngopharyngeal surgery has shown the optimal effectiveness and minimal complications and can be applied to most of the hypopharyngeal sub-sites. All three procedures require a high level of technical skill and close collaboration between otolaryngologists and gastroenterologists.
authors.affiliation: Department of Otorhinolaryngology, Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara, Kanagawa 252-0374, Japan. meijin@med.kitasato-u.ac.jp
authors.forename: Meijin
authors.initials: M
authors.lastname: Nakayama
authors.forename: Chikatoshi
authors.initials: C
authors.lastname: Katada
authors.forename: Tetuo
authors.initials: T
authors.lastname: Mikami
authors.forename: Makito
authors.initials: M
authors.lastname: Okamoto
authors.forename: Wasaburo
authors.initials: W
authors.lastname: Koizumi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tanabe
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Miyamoto
authors.forename: Tabito
authors.initials: T
authors.lastname: Okamoto
authors.forename: Yutomo
authors.initials: Y
authors.lastname: Seino
authors.forename: Koichi
authors.initials: K
authors.lastname: Kano
mesh_terms: D000328:Adult; D000368:Aged; D004210:Dissection; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D005762:Gastroenterology; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology* / Q000601:surgery*; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D009055:Mouth; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D010036:Otolaryngology; D010611:Pharyngectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D014140:Tracheotomy
keywords: endoscopic laryngopharyngeal surgery; endoscopic mucosal resection; endoscopic submucosal dissection; narrow band imaging