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Transoral videolaryngoscopic surgery for oropharyngeal, hypopharyngeal, and supraglottic cancer

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Abstract

In this retrospective cohort study, we evaluated the oncological and functional outcomes of transoral videolaryngoscopic surgery (TOVS). Using distending laryngoscope and videolaryngoscope, wide operative field and working space could be obtained and tumor could be resected in en bloc. Sixty patients with T1, T2, and selected T3 laryngeal or pharyngeal squamous cell carcinomas (Stage I: n = 17, Stage II: n = 16, Stage III: n = 7, Stage IV: n = 20 cases) were enrolled and followed up for at least 24 months or until the patient’s death. Fifty-three patients underwent initial treatment, and seven patients had recurrent cancer after chemoradiation. In principle, node-positive patients underwent a simultaneous neck dissection. Patients with multiple nodal metastases or a positive surgical margin received postoperative radiotherapy. For initial treatment, the 5-year overall survival and disease-specific survival rates were 77 and 95 %, respectively. For supraglottic and hypopharyngeal cancers, the 5-year laryngeal preservation rates were 89 and 96 %, respectively. For salvage surgery, the overall survival, disease-specific survival, and laryngeal preservation rates were 75, 75, and 80 %, respectively. The median times before patients could resume eating and swallowing a soft diet were 6 and 9 days, respectively. The patients’ Functional Outcome Swallowing Scale stages were 0–2 in 93.3 % of the cases and 3 or 4 in 6.7 % of the cases. A percutaneous endoscopic gastrostomy was indicated for 1 (1.7 %) patient. Four (6.7 %) patients received transient tracheostomy. TOVS is a satisfactory and minimally invasive treatment option for laryngeal and pharyngeal cancers.

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References

  1. Hutcheson KA, Lewin JS (2012) Functional outcomes after chemoradiotherapy of laryngeal and pharyngeal cancers. Curr Oncol Rep 14:158–165

    Article  CAS  PubMed  Google Scholar 

  2. Martin A, Jäckel MC, Christiansen H, Mahmoodzada M, Kron M, Steiner W (2008) Organ-preserving transoral laser microsurgery for cancer of the hypopharynx. Laryngoscope 118:398–402

    Article  PubMed  Google Scholar 

  3. Steiner W, Fierek O, Ambrosch P, Hommerich CP, Kron M (2003) Transoral laser microsurgery for squamous cell carcinoma of the base of the tongue. Arch Otolaryngol Head Neck Surg 129:36–43

    Article  PubMed  Google Scholar 

  4. Steiner W, Ambrosch P, Hess CF, Kron M (2001) Organ preservation by transoral laser microsurgery in piriform sinus carcinoma. Otolaryngol Head Neck Surg 124:58–67

    Article  CAS  PubMed  Google Scholar 

  5. Iro H, Waldfahrer F, Altendorf-Hofmann A, Weidenbecher M, Sauer R, Steiner W (1998) Transoral laser surgery of supraglottic cancer: follow-up of 141 patients. Arch Otolaryngol Head Neck Surg 124:1245–1250

    Article  CAS  PubMed  Google Scholar 

  6. Ambrosch P, Kron M, Steiner W (1998) Carbon dioxide laser microsurgery for early supraglottic carcinoma. Ann Otol Rhinol Laryngol 107:680–688

    CAS  PubMed  Google Scholar 

  7. Steiner W, Ambrosch P (2000) Endoscopic laser surgery of the upper aerodigestive tract. Thieme, New York, pp 33–115

    Google Scholar 

  8. O’Malley BW Jr, Weinstein GS, Snyder W, Hockstein NG (2006) Transoral robotic surgery (TORS) for base of tongue neoplasms. Laryngoscope 116:1465–1472

    Article  PubMed  Google Scholar 

  9. Weinstein GS, O’Malley BW Jr, Snyder W, Sherman E, Quon H (2007) Transoral robotic surgery: radical tonsillectomy. Arch Otolaryngol Head Neck Surg 133:1220–1226

    Article  PubMed  Google Scholar 

  10. Park YM, Kim WS, De Virgilio A, Lee SY, Seol JH, Kim SH (2012) Transoral robotic surgery for hypopharyngeal squamous cell carcinoma: 3-year oncologic and functional analysis. Oral Oncol 48:560–566

    Article  PubMed  Google Scholar 

  11. Weinstein GS, O’Malley BW Jr, Snyder W, Hockstein NG (2007) Transoral robotic surgery: supraglottic partial laryngectomy. Ann Otol Rhinol Laryngol 116:19–23

    PubMed  Google Scholar 

  12. Weinstein GS, O’Malley BW Jr, Magnuson JS et al (2012) Transoral robotic surgery: a multicenter study to assess feasibility, safety, and surgical margins. Laryngoscope 122:1701–1707

    Article  PubMed  Google Scholar 

  13. Shiotani A, Tomifuji M, Araki K, Yamashita T, Saito K (2010) Videolaryngoscopic transoral en bloc resection of supraglottic and hypopharyngeal cancers using laparoscopic surgical instruments. Ann Otol Rhinol Laryngol 119:225–232

    PubMed  Google Scholar 

  14. Shiotani A, Tomifuji M, Araki K, Yamashita T (2011) Transoral videolaryngoscopic surgery for en bloc resection of supraglottic and hypopharyngeal cancers. Otolaryngol Head Neck Surg 144:288–289

    Article  PubMed  Google Scholar 

  15. Yamashita T, Tomifuji M, Araki K, Kurioka T, Shiotani A (2011) Endoscopic transoral oropharyngectomy using laparoscopic surgical instruments. Head Neck 33:1315–1321

    Article  PubMed  Google Scholar 

  16. Matsuba H, Katada C, Masaki T et al (2011) Diagnosis of the extent of advanced oropharyngeal and hypopharyngeal cancers by narrow band imaging with magnifying endoscopy. Laryngoscope 121:753–759

    Article  PubMed  Google Scholar 

  17. Salassa JR (1999) A functional outcome swallowing scale for staging oropharyngeal dysphagia. Dig Dis 17:230–234

    Article  CAS  PubMed  Google Scholar 

  18. Tomifuji M, Imanishi Y, Shiotani A et al (2011) Tumor depth as a predictor of lymph node metastasis of supraglottic and hypopharyngeal cancers. Ann Surg Oncol 18:490–496

    Article  PubMed  Google Scholar 

  19. Weinstein GS, O’Malley BW Jr, Cohen MA, Quon H (2010) Transoral robotic surgery for advanced oropharyngeal carcinoma. Arch Otolaryngol Head Neck Surg 136:1079–1085

    Article  PubMed  Google Scholar 

  20. Park YM, Kim WS, Byeon HK, Lee SY, Kim SH (2012) Oncological and functional outcomes of transoral robotic surgery for oropharyngeal cancer. Br J Oral Maxillofac Surg. pii: S0266-4356(12)00526-8

  21. Haughey BH, Hinni ML, Salassa JR et al (2011) Transoral laser microsurgery as primary treatment for advanced-stage oropharyngeal cancer: a United States multicenter study. Head Neck 33:1683–1694

    Article  PubMed  Google Scholar 

  22. Grant DG, Hinni ML, Salassa JR, Perry WC, Hayden RE, Casler JD (2009) Oropharyngeal cancer: a case for single modality treatment with transoral laser microsurgery. Arch Otolaryngol Head Neck Surg 135:1225–1230

    Article  PubMed  Google Scholar 

  23. Rudert HH, Höft S (2003) Transoral carbon-dioxide laser resection of hypopharyngeal carcinoma. Eur Arch Otorhinolaryngol 260:198–206

    PubMed  Google Scholar 

  24. Vilaseca I, Blanch JL, Bernal-Sprekelsen M, Moragas M (2004) CO2 laser surgery: a larynx preservation alternative for selected hypopharyngeal carcinomas. Head Neck 26:953–959

    Article  PubMed  Google Scholar 

  25. Karatzanis AD, Psychogios G, Waldfahrer F et al (2010) T1 and T2 hypopharyngeal cancer treatment with laser microsurgery. J Surg Oncol 102:27–33

    Article  PubMed  Google Scholar 

  26. Motta G, Esposito E, Testa D, Iovine R, Motta S (2004) CO2 laser treatment of supraglottic cancer. Head Neck 26:442–446

    Article  PubMed  Google Scholar 

  27. Grant DG, Salassa JR, Hinni ML, Pearson BW, Hayden RE, Perry WC (2007) Transoral laser microsurgery for carcinoma of the supraglottic larynx. Otolaryngol Head Neck Surg 136:900–906

    Article  PubMed  Google Scholar 

  28. Mendelsohn AH, Remacle M, Van Der Vorst S, Bachy V, Lawson G (2013) Outcomes following transoral robotic surgery: supraglottic laryngectomy. Laryngoscope 123:208–214

    Article  PubMed  Google Scholar 

  29. Salassa JR, Hinni ML, Grant DG, Hayden RE (2008) Postoperative bleeding in transoral laser microsurgery for upper aerodigestive tract tumors. Otolaryngol Head Neck Surg 139:453–459

    Article  PubMed  Google Scholar 

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Acknowledgments

This research was partly supported by Grants-in-aid for Scientific Research (C) from the Japan Society for the Promotion of Science, and a Health and Labor Sciences Research Grant for Clinical Cancer Research (H21-Gannrinshou-Ippan-016) from the Ministry of Health, Labor and Welfare, Japan.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan

    Masayuki Tomifuji, Koji Araki, Taku Yamashita & Akihiro Shiotani

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  1. Masayuki Tomifuji
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  2. Koji Araki
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  3. Taku Yamashita
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  4. Akihiro Shiotani
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Correspondence to Akihiro Shiotani.

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Tomifuji, M., Araki, K., Yamashita, T. et al. Transoral videolaryngoscopic surgery for oropharyngeal, hypopharyngeal, and supraglottic cancer. Eur Arch Otorhinolaryngol 271, 589–597 (2014). https://doi.org/10.1007/s00405-013-2575-0

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  • DOI: https://doi.org/10.1007/s00405-013-2575-0

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