Abe Makoto, Iwamuro Masaya, Kawahara Yoshiro, Kanzaki Hiromitsu, Kawano Seiji, Tanaka Takehiro, Tsumura Munechika, Makino Takuma, Noda Yohei, Marunaka Hidenori, Nishizaki Kazunori, Okada Hiroyuki
Department of Gastroenterology and Hepatology,Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558,
Acta Med Okayama. 2019 Apr;73(2):109-115. doi: 10.18926/AMO/56646.
The efficacy and safety of endoscopic submucosal dissection (ESD) for superficial cancer of the pharynx are still unclear. To identify clinicopathological features of superficial pharyngeal cancer, and the efficacy and safety of ESD, we retrospectively assessed 70 pharyngeal cancers in 59 patients who underwent ESD. Of these patients, 61.0% and 50.8% had a history of esophageal cancer and head and neck cancer, respectively. The median tumor size was 15 mm, and 75.7% of the lesions were located at the piriform sinus. The en bloc resection rate was 94.9%. Treatment-related adverse events occurred in 8 cases, but there was no treatment-related death. The lateral margin was positive for neoplasm in 3 lesions (4.3%) and inconclusive in 27 lesions (38.6%), but no local recurrence was observed. Cervical lymph node metastasis was observed in 6 patients, and was successfully treated by cervical lymph node dissection. The three-year overall survival rate was 91.5% (95%CI: 76.6-97.3%) and the cause-specific survival rate was 97.6% (95%CI: 84.9-99.7%). In conclusion, ESD for superficial pharyngeal cancer was safe and effective. "Resect and watch" is probably a feasible and rational strategy for treatment of patients with superficial pharyngeal cancer.
内镜下黏膜剥离术（ESD）治疗下咽浅表癌的疗效和安全性仍不明确。为明确下咽浅表癌的临床病理特征以及ESD的疗效和安全性，我们回顾性评估了59例行ESD的患者的70例下咽癌。这些患者中，分别有61.0%和50.8%有食管癌和头颈癌病史。肿瘤中位大小为15mm，75.7%的病变位于梨状窝。整块切除率为94.9%。8例发生与治疗相关的不良事件，但无治疗相关死亡。3处病变（4.3%）切缘肿瘤阳性，27处病变（38.6%）切缘不确定，但未观察到局部复发。6例患者观察到颈部淋巴结转移，经颈部淋巴结清扫成功治疗。三年总生存率为91.5%（95%CI：76.6-97.3%），病因特异性生存率为97.6%（95%CI：84.9-99.7%）。总之，ESD治疗下咽浅表癌安全有效。“切除并观察”可能是治疗下咽浅表癌患者的一种可行且合理的策略。
