シンポジウム2
導入化学療法後に行った声門上癌・下咽頭癌に対する 経口的喉頭下咽頭部分切除術
2016 年 28 巻 2 号 p. 61-67
詳細
2016 年 28 巻 2 号 p. 61-67
We performed transoral videolaryngoscopic surgery (TOVS) for hypopharyngeal and supraglottic cancer after induction chemotherapy. The data of 24 patients with hypopharyngeal and supraglottic cancer were retrospectively analyzed. The main tumor site was the hypopharynx in 20 cases and the supraglottis in 4 cases. The number of patients with stage II, III, IVA and IVB tumors were 3, 4, 15 and 2, respectively. Although the mean observation period was relatively short (33 months), the 3-year overall survival was 86%, the disease-specific survival was 94% and the laryngeal preservation rate was 94%. The oncological results and laryngeal preservation rate were excellent.
The pathological findings showed that caution must be taken against local recurrence because of possible satellite residual cancer. In principle, the resection area should be set according to the original tumor extension. Although the resection area was reduced in some cases, we cannot conclude whether or not the resection area can be safely reduced in all cases.
We also examined the need for adjuvant (chemo) radiotherapy. If the resection area was set according to the original tumor extension, negative margin, pT1-2 and pN0-1, adjuvant radiation therapy may be preserved.
