Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.
Department of Pathology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.
J Surg Oncol. 2021 Mar;123(4):872-880. doi: 10.1002/jso.26386. Epub 2021 Jan 26.
Hypopharyngeal cancer (HPC) is well characterized by the early submucosal spread of cancer cells into adjacent subsites of the hypopharynx and deep tissues, advocating a wide extent of treatment. However, the microscopic extensions (ME) from gross tumors, according to the primary tumor dimensions, has not been reported in detail.
We included patients who underwent upfront curative surgery, and retrospectively reviewed pathology specimens from 45 HPC cases. The distance of the MEs, defined as tumor infiltration beyond the gross tumor border on the submucosal and deep sides, was measured. We analyzed potential correlations between MEs and various physical tumor factors.
A rough linear correlation between the submucosal ME and the maximal diameter of tumors was found (p < .001, r = 0.225). Deep MEs did not correlate with tumor physical factors. However, the MEs differed significantly by the T status (p = .033 and .015 in submucosal and deep sides). In T1-2 tumors, the submucosal MEs were less than 0.5 cm, whereas those of T3-4 tumors were 1.5-2.0 cm.
In HPC, local MEs beyond the gross tumor border correlated with primary tumor T status. Our findings support that the surgical safety margin for HPC can be adjusted according to tumor dimension.
下咽癌（HPC）的特点是癌细胞早期向咽旁间隙和深层组织的黏膜下扩散，因此主张进行广泛的治疗。然而，根据大体肿瘤的大小，肿瘤的微观延伸（ME）尚未详细报道。
我们纳入了接受根治性手术的患者，并回顾性分析了 45 例下咽癌患者的病理标本。测量 ME 的距离，定义为黏膜下和深层肿瘤边界外的肿瘤浸润距离。我们分析了 ME 与各种肿瘤物理因素之间的潜在相关性。
在黏膜下 ME 与肿瘤最大直径之间发现了粗略的线性相关性（p<0.001，r=0.225）。深部 ME 与肿瘤物理因素无关。然而，ME 在 T 分期上存在显著差异（p=0.033 和.015 在黏膜下和深部）。在 T1-2 肿瘤中，黏膜下 ME 小于 0.5cm，而 T3-4 肿瘤的 ME 为 1.5-2.0cm。
在 HPC 中，大体肿瘤边界外的局部 ME 与原发肿瘤 T 分期相关。我们的研究结果支持根据肿瘤尺寸调整下咽癌的手术安全边界。
