Division of Endoscopy, Shizuoka Cancer Center, Nagaizumi, Suntogun, Shizuoka, Japan.
Gastrointest Endosc. 2013 Jul;78(1):22-9. doi: 10.1016/j.gie.2013.01.047. Epub 2013 Mar 26.
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.
To evaluate the feasibility of a "resect and watch" strategy with ER for SPC.
Retrospective, single-center cohort study.
Tertiary cancer center.
A total of 32 patients with 47 SPCs were eligible.
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.
Complications, tumor recurrence, development of metachronous pharyngeal cancer, overall survival, and cause-specific survival.
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.
Retrospective nature, single-center setting, relatively small sample size.
A "resect and watch" strategy with ER for SPC is feasible and rational.
对于表浅性咽癌（SPC），内镜下切除（ER）后，如果可能存在不完全切除，可能需要进行根治性手术切除或放疗等额外治疗。但是，预防性附加治疗的益处尚不清楚。
评估 ER 治疗 SPC 的“切除并观察”策略的可行性。
回顾性、单中心队列研究。
三级癌症中心。
共有 32 名患者的 47 个 SPC 符合入选条件。
采用“切除并观察”策略，即初始 ER 治疗，然后观察，直到发生包括局部复发、颈部淋巴结转移（LNM）和异时性咽癌在内的继发病变。
并发症、肿瘤复发、异时性咽癌的发生、总生存和病因特异性生存。
无与 ER 相关的严重并发症。中位随访时间为 43 个月（范围，7-76 个月）。5 年时继发性疾病的累积发生率为 44%（95%CI，24.5%-63.8%）。4 例局部复发（N=4）和 5 例颈部 LNM（N=5）通过局部切除术（2 例部分手术切除和 2 例额外 ER）和颈部清扫术成功治疗。6 例异时性咽癌（N=6）通过 ER 完全切除。5 年时的总生存率和病因特异性生存率分别为 84.4%（95%CI，70.0%-98.8%）和 100%。无患者需要额外的根治性手术治疗。因此，所有患者的喉及其功能都得到了保留。
回顾性研究、单中心设置、样本量相对较小。
ER 治疗 SPC 的“切除并观察”策略是可行且合理的。
