内镜黏膜下剥离术治疗下咽浅表性鳞状细胞肿瘤的安全性和有效性：一项中国单中心研究

The safety and efficacy of endoscopic submucosal dissection for superficial pharyngeal squamous cell neoplasms: a single-center study in China.

作者信息

Dai Xinghang, Liu Yi, Dou Lizhou, Zhang Yueming, Liu Yong, Song Shibo, Wang Guiqi, He Shun

机构信息

Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, NO.17 Panjiayuan.Chaoyang District, Beijing, 100021, China.

Department of Endoscopic Center, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361003, China.

出版信息

Surg Endosc. 2025 Jun;39(6):3600-3609. doi: 10.1007/s00464-025-11636-1. Epub 2025 Apr 21.

DOI:10.1007/s00464-025-11636-1

PMID:40259092

Abstract

BACKGROUND AND AIMS

Endoscopic submucosal dissection (ESD) is a mainstream treatment for superficial pharyngeal squamous cell neoplasms (SPSCN) in Japan. There were few reports of it in China, which were small in scale and lack long-term follow-up data. Quality of life (QoL) outcomes of ESD for SPSCN have also not been studied. The aims of this study were to clarify the safety and efficacy of ESD for SPSCN and its outcomes in the Chinese setting.

METHODS

Eighty-four consecutive patients with 145 lesions treated with ESD for SPSCN from January 2014 to August 2022 were enrolled. Their curability, complications, metachronous SPSCN, local recurrence, lymph node metastasis, and overall and disease-specific survival rates were analyzed. The quality of life was measured by MD Anderson Symptom Inventory-Head and Neck (MDASI-HN).

RESULTS

The en-bloc resection rate was 94.5%, and the R0 resection rate was 74.5%. The postoperative adverse event rate was 2.6%. The median follow-up period was 36.28 months. The 3-year rates of metachronous pharyngeal cancer, local recurrence, lymph node metastasis, overall survival, and disease-specific survival were 14.1%, 7.6%, 9.6%, 92.4%, and 98.0%, respectively. The mean symptom composite score and interference score of MDASI-HN were 10.3 and 2.3, respectively.

CONCLUSIONS

In the Chinese setting, pharyngeal ESD achieves curability, safety, and long-term outcomes comparable to those observed in Japan. The postoperative QoL is satisfactory.

摘要

背景与目的

在日本，内镜黏膜下剥离术（ESD）是治疗浅表性咽鳞状细胞肿瘤（SPSCN）的主流方法。在中国，关于该手术的报道较少，且规模较小，缺乏长期随访数据。ESD治疗SPSCN的生活质量（QoL）结果也尚未得到研究。本研究的目的是阐明ESD治疗SPSCN在中国的安全性、有效性及其结果。

方法

纳入2014年1月至2022年8月连续84例接受ESD治疗SPSCN的患者，共145个病变。分析其治愈率、并发症、异时性SPSCN、局部复发、淋巴结转移以及总生存率和疾病特异性生存率。采用MD安德森症状评估量表-头颈版（MDASI-HN）测量生活质量。

结果

整块切除率为94.5%，R0切除率为74.5%。术后不良事件发生率为2.6%。中位随访期为36.28个月。异时性咽癌、局部复发、淋巴结转移、总生存率和疾病特异性生存率的3年发生率分别为14.1%、7.6%、9.6%、92.4%和98.0%。MDASI-HN的平均症状综合评分和干扰评分别为10.3和2.3。