Transoral radiofrequency coblation surgery for the treatment of hypopharyngeal carcinoma
10.3760/cma.j.issn.1673-0860.2017.05.002
- VernacularTitle: 等离子射频辅助经口手术治疗下咽癌
- Author:
Shuifang XIAO
1
;
Wuyi LI
2
;
Junbo ZHANG
1
;
Jian WANG
2
;
Junxiao JIA
1
;
Dahai YANG
2
;
Xin ZHAO
1
;
Hong HUO
2
;
Hong SHEN
1
Author Information
1. Department of Otorhinolaryngology Head and Neck Surgery, Peking University First Hospital, Beijing 100034, China
2. Department of Otorhinolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
- Publication Type:Journal Article
- Keywords:
Hypopharyngeal carcinoma;
Radiofrequency coblation;
Transoral surgery
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2017;52(5):325-331
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the feasibility and effectiveness of transoral surgery (TOS) for the treatment of hypopharyngeal carcinoma by means of the radiofrequency coblation(RFC).
Methods:Twenty-two patients with hypopharyngeal carcinoma who were treated with TOS using RFC during the years of 2010-2016 were enrolled. Among these patients, 15 suffered from pyriform sinus carcinoma, 4 suffered from postcricoid carcinoma, and 3 suffered from posterior hypopharyngeal wall carcinoma. According to the AJCC 2002 guideline, the tumor stages were T1N0M0 for 3 patients, T2N0M0 for 9 patients, T1N1M0 for 1 patient, T1N2M0 for 1 patient, T2N1M0 for 4 patients, and T2N2M0 for 4 patients respectively. All patients with N+ underwent concurrent neck dissection; 2 patients underwent concurrent prophylactic tracheotomy; 17 underwent post-operative radiotherapy for 50-66 Gy. The follow-up time was 6-72 months with a median 35 months.Two patients were lost to follow-up.
Results:All patients except 2 underwent the TOS successfully, while the two patients were treated with open approach surgery due to unsure safe margin. Most patients returned to oral feeding within one week. Among the 18 patients with complete follow up data, 3 had the local recurrence of the tumor (16.7%) and one died due to local recurrence, multiple primary esophageal carcinoma, and distant metastasis 4 years after surgery (5.6%). According to the Kaplan-Meier method, the 5-years local control rate and survival rate were 57.8% and 67.5% respectively. All patients had no disorders in speech, swallowing and respiration during the follow up.
Conclusions:The RFC can be applied in TOS for the treatments of hypopharyngeal carcinoma with high cutting efficiency and better control of intraoperative hemorrhage, which is useful in lowering the operation difficulty. The oncologic results are comparable to the open surgery with satisfactory postoperative organ function preservation.
