Lateral pharyngotomy approach in the treatment of oropharyngeal carcinoma.
Surgery for early-intermediate oropharyngeal squamous cell carcinoma (OPSCC) may involve using transoral endoscopic approaches or open surgical procedures. "Lateral pharyngotomy" (LP) is an open surgical approach that improves exposure of the oropharyngeal region, while avoiding mandibulotomy. The aim of the present study was to retrospectively analyze our experience with the surgical treatment of early-intermediate OPSCC using the LP approach, and to investigate the potentially prognostic clinical and/or pathological factors that might identify patients at higher risk of recurrence after primary surgery. Sixty-four patients with previously untreated early-intermediate (pT1-T2-T3) OPSCC consecutively underwent partial pharyngectomy using a LP approach, performed by the same surgical team at a tertiary head and neck oncology center (Otolaryngology Unit, Vittorio Veneto Hospital, Italy). The 2-year disease-specific survival rates were 86% for stage I-II and 77% for stage III-IV disease. All patients who experienced locoregional or distant metastases died of their disease, while no patients died of any complications of the treatment. Postoperative complications occurred in 25 patients (39%), the most common being pharyngocutaneous fistula. All but one of the patients experienced a complete recovery of oral food intake. In conclusion, the LP approach to oropharyngeal cancer could be a valid open surgical alternative to oropharyngectomy with mandibulotomy for: (a) patients with early-intermediate OPSCC in whom oropharyngeal exposure proves difficult, and/or who are not eligible for transoral endoscopic surgery; (b) HPV-negative OPSCCs; and
Otolaryngology Unit, Vittorio Veneto Hospital, Vittorio Veneto, Italy.
Andy
A
Bertolin
Otolaryngology Unit, Vittorio Veneto Hospital, Vittorio Veneto, Italy.
Guido
G
Ghirardo
Otolaryngology Unit, Vittorio Veneto Hospital, Vittorio Veneto, Italy. marcolionello@email.it.
Marco
M
Lionello
Department of Medicine DIMED, University of Padua, Padova, Italy.
Luciano
L
Giacomelli
Otolaryngology Unit, Vittorio Veneto Hospital, Vittorio Veneto, Italy.
Marco
M
Lucioni
Otolaryngology Unit, Vittorio Veneto Hospital, Vittorio Veneto, Italy.
Giuseppe
G
Rizzotto
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D037981:Neck Dissection; D009367:Neoplasm Staging; D019647:Oral Surgical Procedures / Q000379:methods*; D009959:Oropharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D010614:Pharynx / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures; D015996:Survival Rate
Lateral pharyngotomy; Oropharyngeal carcinoma; Outcome; Pharyngectomy; Prognosis