Abstract
Objective: We have previously reported that narrow band imaging (NBI) combined with magnifying endoscopy is useful in detecting early superficial pharyngeal cancers, which are difficult to detect with a standard endoscopy. In this study, we investigated the usefulness of submucosal dissection for such superficial lesions of pharyngeal cancer retrospectively.
Method: Fifty patients with superficial pharyngeal cancer were treated since September 2007. Under general anesthesia, a curved laryngoscope was inserted trans-orally, the extent of the lesion was determined by the NBI endoscope, and the lesion was dissected with an orally inserted curved electric knife.
Results: Tracheostomy was performed in 5 cases, which had synchronous multiple lesions in the hypopharynx. Regarding adverse effects, postoperative bleeding occurred in one case, which needed emergency tracheostomy. With a median follow-up period of 20 months, metachronous multiple laryngo-pharyngeal cancer occurred in 4 cases and recurrence occurred in 2 cases. All the metachronous cancer cases and the recurrent case were controlled with additional endoscopic submucosal dissection. The cause-specific survival rates at 2 years were 100%. All the patients retained their pharynx and their speaking, breathing, and swallowing functions.
Conclusion: Endoscopic submucosal dissection for early pharyngeal cancer allows excellent survival and preservation of swallowing and voice functions. Early detection of superficial pharyngeal cancer with narrow band imaging technology and treatment with endoscopic submucosal dissection can be a new treatment strategy for head and neck cancer.
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