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Outcomes of Endoscopic Submucosal Dissection for Treatment of Superficial Pharyngeal Cancers: Systematic Review and Meta-Analysis

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Abstract

Background and Aims

Studies evaluating the role of endoscopic submucosal dissection (ESD) in the management of superficial pharyngeal cancers have reported promising results. This meta-analysis evaluates the efficacy and safety of ESD in the management of superficial pharyngeal cancers.

Methods

We reviewed several databases from inception to September 03, 2020, to identify studies evaluating the efficacy and safety of ESD in the management of superficial pharyngeal cancers. Our outcomes of interest were en bloc resection rate, complete resection rate, adverse events, and rates of local recurrence. Pooled rates with 95% confidence intervals (CI) for all outcomes were calculated using random-effect model. Heterogeneity was assessed by I2 statistic. We assessed publication bias by using funnel plots and Egger’s test. We conducted meta-regression analysis to explore heterogeneity in analyses.

Results

Ten studies were included in analyses. All studies were from Asia. Pooled rates (95% CI) for en bloc resection and complete resection were 94% (87%, 97%) and 72% (62%, 80%), respectively. The pooled rates (95% CI) for adverse events and local recurrence were 10% (5%, 17%) and 1.9% (0.9%, 4%), respectively. Most of the analyses were limited by substantial heterogeneity. On meta-regression analysis, the heterogeneity was explained by size of tumor and histology. Funnel plots and Egger’s test showed no evidence of publication bias.

Conclusions

This meta-analysis including studies from Asian countries demonstrated that ESD is an efficacious and safe option in the management of superficial pharyngeal cancers. More studies and studies from Western countries are needed to further validate these findings.

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References

  1. Muto M, Minashi K, Yano T et al. Early detection of superficial squamous cell carcinoma in the head and neck region and esophagus by narrow band imaging: a multicenter randomized controlled trial. J Clin Oncol 2010;28:1566–1572.

    Article  Google Scholar 

  2. Nonaka S, Saito Y. Endoscopic diagnosis of pharyngeal carcinoma by NBI. Endoscopy 2008;40:347–351.

    Article  CAS  Google Scholar 

  3. Ugumori T, Muto M, Hayashi R, Hayashi T, Kishimoto S. Prospective study of early detection of pharyngeal superficial carcinoma with the narrowband Imaging laryngoscope. Head Neck 2009;31:189–194.

    Article  Google Scholar 

  4. Muto M, Nakane M, Katada C et al. Squamous cell carcinoma in situ at oropharyngeal and hypopharyngeal mucosal sites. Cancer 2004;101:1375–1381.

    Article  Google Scholar 

  5. Fang FM, Tsai WL, Chien CY et al. Changing quality of life in patients with advanced head and neck cancer after primary radiotherapy or chemoradiation. Oncology 2005;68:405–413.

    Article  Google Scholar 

  6. Eckel HE, Staar S, Volling P, Sittel C, Damm M, Jungehuelsing M. Surgical treatment for hypopharynx carcinoma: feasibility, mortality, and results. Otolaryngol Head Neck Surg 2001;124:561–569.

    Article  CAS  Google Scholar 

  7. Ngamruengphong S, Ferri L, Aihara H et al. Efficacy of endoscopic submucosal dissection for superficial gastric neoplasia in a large cohort in North America. Clin Gastroenterol Hepatol. 2021;19:1611–1619.

    Article  Google Scholar 

  8. Pimentel-Nunes P, Dinis-Ribeiro M, Ponchon T et al. Endoscopic submucosal dissection: European society of gastrointestinal endoscopy (ESGE) guideline. Endoscopy 2015;47:829–854.

    Article  Google Scholar 

  9. Tate DJ, Klein A, Sidhu M et al. Endoscopic submucosal dissection for suspected early gastric cancer: absolute versus expanded criteria in a large Western cohort (with video). Gastrointest Endosc 2019;90:467–79 e4.

    Article  Google Scholar 

  10. Iizuka T, Kikuchi D, Suzuki Y, Tanaka M, Takeda H. Clinical relevance of endoscopic treatment for superficial pharyngeal cancer: feasibility of techniques corresponding to each location and long-term outcomes. Gastrointestinal Endosc. 2020;93:818–827.

    Article  Google Scholar 

  11. Abe M, Iwamuro M, Kawahara Y et al. Clinicopathological features and outcomes of endoscopic submucosal dissection for superficial cancer of the pharynx. Acta Med Okayama 2019;73:109–115.

    PubMed  Google Scholar 

  12. Okada K, Tsuchida T, Ishiyama A et al. Endoscopic mucosal resection and endoscopic submucosal dissection for en bloc resection of superficial pharyngeal carcinomas. Endoscopy 2012;44:556–564.

    Article  CAS  Google Scholar 

  13. Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J. Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg 2003;73:712–716.

    Article  Google Scholar 

  14. Vanella G, Crippa S, Archibugi L et al. Meta-analysis of mortality in patients with high-risk intraductal papillary mucinous neoplasms under observation. Br J Surg 2018;105:328–338.

    Article  CAS  Google Scholar 

  15. Elkhadem A, Mickan S, Richards D. Adverse events of surgical extrusion in treatment for crown-root and cervical root fractures: a systematic review of case series/reports. Dent Traumatol 2014;30:1–14.

    Article  Google Scholar 

  16. Lee JH, Chen KM, Chang CH, Liu YT, Yang CC. Endoscopic submucosal dissection for superficial pharyngeal squamous cell carcinoma. Adv Digest Med. 2021;8:33–39.

    Article  Google Scholar 

  17. Yoshio T, Tsuchida T, Ishiyama A et al. Efficacy of double-scope endoscopic submucosal dissection and long-term outcomes of endoscopic resection for superficial pharyngeal cancer. Gastroenterol Endosc. 2017;59:2750–2759.

    Google Scholar 

  18. Kinjo Y, Nonaka S, Oda I et al. The short-term and long-term outcomes of the endoscopic resection for the superficial pharyngeal squamous cell carcinoma. Endosc Int Open. 2015;3:E266–E273.

    Article  Google Scholar 

  19. Hanaoka N, Ishihara R, Takeuchi Y et al. Endoscopic submucosal dissection as minimally invasive treatment for superficial pharyngeal cancer: a phase II study (with video). Gastrointest Endosc 2015;82:1002–1008.

    Article  Google Scholar 

  20. Hanaoka N, Ishihara R, Takeuchi Y et al. Clinical outcomes of endoscopic mucosal resection and endoscopic submucosal dissection as a transoral treatment for superficial pharyngeal cancer. Head Neck 2013;35:1248–1254.

    Article  Google Scholar 

  21. Kuwabara T, Hiyama T, Oka S et al. Clinical features of pharyngeal intraepithelial neoplasias and outcomes of treatment by endoscopic submucosal dissection. Gastrointest Endosc. 2012;76:1095–1103.

    Article  Google Scholar 

  22. Shimizu Y, Yamamoto J, Kato M et al. Endoscopic submucosal dissection for treatment of early stage hypopharyngeal carcinoma. Gastrointest Endosc. 2006;64:255–259.

    Article  Google Scholar 

  23. Tateya I, Shiotani A, Satou Y et al. Transoral surgery for laryngo-pharyngeal cancer—the paradigm shift of the head and cancer treatment. Auris Nasus Larynx 2016;43:21–32.

    Article  Google Scholar 

  24. Weinstein GS, O’Malley BW Jr, Desai SC, Quon H. Transoral robotic surgery: does the ends justify the means? Curr Opin Otolaryngol Head Neck Surg 2009;17:126–131.

    Article  Google Scholar 

  25. Kishimoto Y, Tateya I, Funakoshi M, Miyamoto SI, Muto M, Omori K. Endoscopic laryngopharyngeal surgery for hypopharyngeal lesions. Oral Oncol 2020;106:104655.

    Article  Google Scholar 

  26. Tateya I, Muto M, Morita S et al. Endoscopic laryngo-pharyngeal surgery for superficial laryngo-pharyngeal cancer. Surg Endosc 2016;30:323–329.

    Article  Google Scholar 

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Funding

This project was not funded by any source.

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Authors and Affiliations

  1. Division of Gastroenterology, University of Tennessee Health Science Center, Memphis, TN, USA

    Faisal Kamal

  2. Department of Gastroenterology, Hepatology and Nutrition, University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Muhammad Ali Khan

  3. Mulford Health Sciences Library, University of Toledo, Toledo, OH, USA

    Wade Lee-Smith

  4. Department of Medicine, University of Toledo, Toledo, OH, USA

    Sachit Sharma & Ashu Acharya

  5. Division of Gastroenterology, William Beaumont Hospital, Royal Oak, MI, USA

    Zaid Imam

  6. Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA

    Dawit Jowhar, Ellen Petryna & Julia Esswein

  7. Division of Gastroenterology, University of Toledo, Toledo, OH, USA

    Muhammad Aziz

  8. Department of Medicine, Loyola Medicine/MacNeal Hospital, Berwyn, IL, USA

    Umer Farooq

  9. Department of Medicine, Lehigh Valley Health Network, Allentown, PA, USA

    Usman Zafar

  10. Division of Gastroenterology, University of Utah, Salt Lake City, UT, USA

    Stephanie Mcdonough

  11. Center for Advanced Therapeutic Endoscopy (CATE), Porter Adventist Hospital, 2525 S Downing St, Denver, CO, 80210, USA

    Douglas G. Adler

Authors
  1. Faisal Kamal
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  2. Muhammad Ali Khan
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  3. Wade Lee-Smith
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  9. Ashu Acharya
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  10. Muhammad Aziz
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  14. Douglas G. Adler
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Correspondence to Douglas G. Adler.

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Kamal, F., Khan, M.A., Lee-Smith, W. et al. Outcomes of Endoscopic Submucosal Dissection for Treatment of Superficial Pharyngeal Cancers: Systematic Review and Meta-Analysis. Dig Dis Sci 67, 3518–3528 (2022). https://doi.org/10.1007/s10620-021-07225-6

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  • DOI: https://doi.org/10.1007/s10620-021-07225-6

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