Abstract
Surgery for early-intermediate oropharyngeal squamous cell carcinoma (OPSCC) may involve using transoral endoscopic approaches or open surgical procedures. “Lateral pharyngotomy” (LP) is an open surgical approach that improves exposure of the oropharyngeal region, while avoiding mandibulotomy. The aim of the present study was to retrospectively analyze our experience with the surgical treatment of early-intermediate OPSCC using the LP approach, and to investigate the potentially prognostic clinical and/or pathological factors that might identify patients at higher risk of recurrence after primary surgery. Sixty-four patients with previously untreated early-intermediate (pT1–T2–T3) OPSCC consecutively underwent partial pharyngectomy using a LP approach, performed by the same surgical team at a tertiary head and neck oncology center (Otolaryngology Unit, Vittorio Veneto Hospital, Italy). The 2-year disease-specific survival rates were 86% for stage I–II and 77% for stage III–IV disease. All patients who experienced locoregional or distant metastases died of their disease, while no patients died of any complications of the treatment. Postoperative complications occurred in 25 patients (39%), the most common being pharyngocutaneous fistula. All but one of the patients experienced a complete recovery of oral food intake. In conclusion, the LP approach to oropharyngeal cancer could be a valid open surgical alternative to oropharyngectomy with mandibulotomy for: (a) patients with early-intermediate OPSCC in whom oropharyngeal exposure proves difficult, and/or who are not eligible for transoral endoscopic surgery; (b) HPV-negative OPSCCs; and (c) patients unfit for or refusing chemoradiotherapy.
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Acknowledgements
The authors thank Frances Coburn for correcting the English version of this paper. They also thank all the medical and paramedical staff at the Otolaryngology Unit-Vittorio Veneto Hospital, for collecting the follow-up data.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Bertolin, A., Ghirardo, G., Lionello, M. et al. Lateral pharyngotomy approach in the treatment of oropharyngeal carcinoma. Eur Arch Otorhinolaryngol 274, 2573–2580 (2017). https://doi.org/10.1007/s00405-017-4538-3
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DOI: https://doi.org/10.1007/s00405-017-4538-3