Efficacy of double-scope endoscopic submucosal dissection and long-term outcomes of endoscopic resection for superficial pharyngeal carcinomas

Objectives

Owing to increased awareness and the use of narrow band imaging, there are more opportunities to treat superficial pharyngeal cancer (SPC). This study aimed to describe the short- and long-term outcomes of ER (endoscopic resection) for SPC.

Methods

This study included 166 consecutive SPCs in 113 patients treated during 2006-2013 at one referral cancer center. In the first period, we treated patients using endoscopic mucosal resection (EMR), in the second period using conventional ESD (cESD) and in the recent period using double-scope ESD (dsESD), which involves a second thin endoscope for assistance to produce traction. The median follow-up period was 30 months.

Results

All lesions were diagnosed as squamous cell carcinoma. The complete resection rate of the cESD and dsESD procedures was 56.4% and 82.3% (p < 0.01), and the local recurrence rate was 2.6% and 0.0%, respectively. The procedure duration was significantly shorter for dsESD than for cESD (p < 0.05). Four cases of recurrent lymph node (LN) metastasis were observed; however, all patients with LN metastases survived to a 48-month median interval after neck dissection. Risk factors for LN metastasis included SEP invasion, tumor thickness >1000 µm, droplet infiltration, and lymphovascular invasion. The overall survival rate after 5 years was 79.5%; no patients died due to SPC. The cumulative rate of metachronous SPC after 5 years was 46.5%.

Conclusion

ER for SPC is a feasible and effective treatment, although metachronous SPC occurred frequently. For the technics of ER, dsESD was effective.

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