A prospective clinical trial of the second‐look procedure for transoral surgery in patients with T1 and T2 laryngeal, oropharyngeal, and hypopharyngeal cancer
Abstract Background Transoral surgery (TOS) has been widely applied for early T‐stage head and neck cancer (HNC). The resection is performed with a minimum safety margin for function preservation under a limited surgical field; therefore, it is difficult to have a strong conviction about the complet...
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| Format: | Article |
| Language: | English |
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Wiley
2019-12-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.2588 |
| _version_ | 1818389065022570496 |
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| author | Goshi Nishimura Daisuke Sano Yasuhiro Arai Takashi Hatano Hideaki Takahashi Teruhiko Tanabe Takashi Wada Daiki Morishita Nobuhiko Oridate |
| author_facet | Goshi Nishimura Daisuke Sano Yasuhiro Arai Takashi Hatano Hideaki Takahashi Teruhiko Tanabe Takashi Wada Daiki Morishita Nobuhiko Oridate |
| author_sort | Goshi Nishimura |
| collection | DOAJ |
| description | Abstract Background Transoral surgery (TOS) has been widely applied for early T‐stage head and neck cancer (HNC). The resection is performed with a minimum safety margin for function preservation under a limited surgical field; therefore, it is difficult to have a strong conviction about the complete resection. This study aims to evaluate the completeness of the initial TOS procedure; possibility of primary control by TOS alone; and predictive factors in patients with early T‐stage laryngeal, oropharyngeal, and hypopharyngeal cancer. Methods Patients were treated by TOS at the primary site with or without neck dissection. The patients were divided into two groups based on the pathological evaluation of their surgical specimens: the control (observation) group, in that the resection was considered complete and the intervention (second‐look procedure) group, in that incomplete tumor resection was suspected. The predictive factors for the possibility and/or limitations of complete resection by TOS were then analyzed. Results The study enrolled 26 and 25 patients in the control and intervention group, respectively. The success rate for single resection was 66% and the predictive factor was tumor depth obtained by enhanced computed tomography (CT) examination (odds ratio, 7.870, P = .0243). The success rate for definitive therapy by TOS alone was 83% and the predictive factor was poor differentiation observed on pathological examination (odds ratio, 6.800, P = .0248). Conclusions TOS has the potential for both definitive resection and function preservation with minimal invasiveness. Identification of the risk factors for TOS is advantageous for accurate treatment selection in patients with early T‐stage HNC. |
| first_indexed | 2024-12-14T04:35:48Z |
| format | Article |
| id | doaj.art-6f086c5140a24a27a48c40f2c5d6a6c6 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-12-14T04:35:48Z |
| publishDate | 2019-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-6f086c5140a24a27a48c40f2c5d6a6c62022-12-21T23:16:58ZengWileyCancer Medicine2045-76342019-12-018177197720610.1002/cam4.2588A prospective clinical trial of the second‐look procedure for transoral surgery in patients with T1 and T2 laryngeal, oropharyngeal, and hypopharyngeal cancerGoshi Nishimura0Daisuke Sano1Yasuhiro Arai2Takashi Hatano3Hideaki Takahashi4Teruhiko Tanabe5Takashi Wada6Daiki Morishita7Nobuhiko Oridate8Department of Otorhinolaryngology, Head and Neck Surgery School of Medicine Yokohama City University Yokohama JapanDepartment of Otorhinolaryngology, Head and Neck Surgery School of Medicine Yokohama City University Yokohama JapanDepartment of Otorhinolaryngology, Head and Neck Surgery School of Medicine Yokohama City University Yokohama JapanDepartment of Otorhinolaryngology, Head and Neck Surgery School of Medicine Yokohama City University Yokohama JapanDepartment of Otorhinolaryngology, Head and Neck Surgery School of Medicine Yokohama City University Yokohama JapanDepartment of Otorhinolaryngology, Head and Neck Surgery School of Medicine Yokohama City University Yokohama JapanDepartment of Otorhinolaryngology, Head and Neck Surgery School of Medicine Yokohama City University Yokohama JapanDepartment of Otorhinolaryngology, Head and Neck Surgery School of Medicine Yokohama City University Yokohama JapanDepartment of Otorhinolaryngology, Head and Neck Surgery School of Medicine Yokohama City University Yokohama JapanAbstract Background Transoral surgery (TOS) has been widely applied for early T‐stage head and neck cancer (HNC). The resection is performed with a minimum safety margin for function preservation under a limited surgical field; therefore, it is difficult to have a strong conviction about the complete resection. This study aims to evaluate the completeness of the initial TOS procedure; possibility of primary control by TOS alone; and predictive factors in patients with early T‐stage laryngeal, oropharyngeal, and hypopharyngeal cancer. Methods Patients were treated by TOS at the primary site with or without neck dissection. The patients were divided into two groups based on the pathological evaluation of their surgical specimens: the control (observation) group, in that the resection was considered complete and the intervention (second‐look procedure) group, in that incomplete tumor resection was suspected. The predictive factors for the possibility and/or limitations of complete resection by TOS were then analyzed. Results The study enrolled 26 and 25 patients in the control and intervention group, respectively. The success rate for single resection was 66% and the predictive factor was tumor depth obtained by enhanced computed tomography (CT) examination (odds ratio, 7.870, P = .0243). The success rate for definitive therapy by TOS alone was 83% and the predictive factor was poor differentiation observed on pathological examination (odds ratio, 6.800, P = .0248). Conclusions TOS has the potential for both definitive resection and function preservation with minimal invasiveness. Identification of the risk factors for TOS is advantageous for accurate treatment selection in patients with early T‐stage HNC.https://doi.org/10.1002/cam4.2588early T‐stage head and neck cancerlocoregional controlpredictive factorssecond‐look proceduretransoral surgery |
| spellingShingle | Goshi Nishimura Daisuke Sano Yasuhiro Arai Takashi Hatano Hideaki Takahashi Teruhiko Tanabe Takashi Wada Daiki Morishita Nobuhiko Oridate A prospective clinical trial of the second‐look procedure for transoral surgery in patients with T1 and T2 laryngeal, oropharyngeal, and hypopharyngeal cancer Cancer Medicine early T‐stage head and neck cancer locoregional control predictive factors second‐look procedure transoral surgery |
| title | A prospective clinical trial of the second‐look procedure for transoral surgery in patients with T1 and T2 laryngeal, oropharyngeal, and hypopharyngeal cancer |
| title_full | A prospective clinical trial of the second‐look procedure for transoral surgery in patients with T1 and T2 laryngeal, oropharyngeal, and hypopharyngeal cancer |
| title_fullStr | A prospective clinical trial of the second‐look procedure for transoral surgery in patients with T1 and T2 laryngeal, oropharyngeal, and hypopharyngeal cancer |
| title_full_unstemmed | A prospective clinical trial of the second‐look procedure for transoral surgery in patients with T1 and T2 laryngeal, oropharyngeal, and hypopharyngeal cancer |
| title_short | A prospective clinical trial of the second‐look procedure for transoral surgery in patients with T1 and T2 laryngeal, oropharyngeal, and hypopharyngeal cancer |
| title_sort | prospective clinical trial of the second look procedure for transoral surgery in patients with t1 and t2 laryngeal oropharyngeal and hypopharyngeal cancer |
| topic | early T‐stage head and neck cancer locoregional control predictive factors second‐look procedure transoral surgery |
| url | https://doi.org/10.1002/cam4.2588 |
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