Endoscopy 2015; 47(01): 11-18
DOI: 10.1055/s-0034-1378107
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Clinical outcome after endoscopic resection for superficial pharyngeal squamous cell carcinoma invading the subepithelial layer

Hironaga Satake
1  Department of Gastroenterology, Endoscopy Division, National Cancer Center Hospital East, Kashiwa, Japan
,
Tomonori Yano
1  Department of Gastroenterology, Endoscopy Division, National Cancer Center Hospital East, Kashiwa, Japan
,
Manabu Muto
2  Department of Clinical Oncology, Kyoto University Graduate School of Medicine, Kyoto, Japan
,
Keiko Minashi
1  Department of Gastroenterology, Endoscopy Division, National Cancer Center Hospital East, Kashiwa, Japan
,
Yusuke Yoda
1  Department of Gastroenterology, Endoscopy Division, National Cancer Center Hospital East, Kashiwa, Japan
,
Takashi Kojima
1  Department of Gastroenterology, Endoscopy Division, National Cancer Center Hospital East, Kashiwa, Japan
,
Yasuhiro Oono
1  Department of Gastroenterology, Endoscopy Division, National Cancer Center Hospital East, Kashiwa, Japan
,
Hiroaki Ikematsu
1  Department of Gastroenterology, Endoscopy Division, National Cancer Center Hospital East, Kashiwa, Japan
,
Ikuo Aoyama
3  Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
,
Shuko Morita
3  Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
,
Shinichi Miyamoto
3  Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
,
Satoshi Fujii
4  Pathology Division, Research Center for Innovative Oncology, National Cancer Center, Kashiwa, Japan
,
Akihiko Yoshizawa
5  Department of Laboratory Medicine, Shinshu University Hospital, Nagano, Japan
,
Atsushi Ochiai
4  Pathology Division, Research Center for Innovative Oncology, National Cancer Center, Kashiwa, Japan
,
Ryuichi Hayashi
6  Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan
,
Kazuhiro Kaneko
1  Department of Gastroenterology, Endoscopy Division, National Cancer Center Hospital East, Kashiwa, Japan
› Author Affiliations
Further Information

Publication History

submitted 03 December 2013

accepted after revision 17 July 2014

Publication Date:
30 September 2014 (online)

Background and study aims: The curability of endoscopic resection for superficial pharyngeal squamous cell carcinoma (SPSCC) has not been fully elucidated, particularly for lesions invading the subepithelial layer, which carry the risk of metastasis. The aim of this study was to evaluate the curative potential of endoscopic resection for SPSCC invading the subepithelial layer.

Patients and methods: From June 2002 to July 2010, 198 SPSCCs in 176 consecutive patients were treated by endoscopic resection at two tertiary referral centers. Selection criteria were initial endoscopic resection, histologically proven squamous cell carcinoma invading the subepithelial layer, no lymph node or distant metastasis before endoscopic resection, and no prior treatment for pharyngeal squamous cell carcinoma. Endoscopic resection was performed under general anesthesia. Long-term survival and clinical outcomes were retrospectively evaluated.

Results: Among 176 consecutive patients, 50 lesions in 47 patients (all male; median age 64 years) were histologically diagnosed from endoscopic resection specimens as having subepithelial invasion. Median tumor thickness was 1000 μm (range 200 – 10 000 μm). Six patients developed local recurrence (13 %; 95 % confidence interval [CI] 3.1 % – 22.4 %), and all were cured with organ-preserving intervention. After a median follow-up period of 71 months (range 27 – 116 months), one patient (2 %; 95 %CI 0 – 6.3 %) developed neck lymph node metastasis. A total of 14 patients (30 %) were followed for 5 years or more, and 5-year overall survival and disease-specific survival rates were 84.5 % (95 %CI 73 % – 96 %) and 100 %, respectively.

Conclusions: Endoscopic resection has curative potential as a minimally invasive treatment option for SPSCC that invades the subepithelial layer.