Parul Sinha1, Patrik Pipkorn1, Joseph Zenga1, Bruce H Haughey2,3. 1. 1 Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA. 2. 2 Department of Head and Neck Surgery, Florida Hospital Celebration Health, Celebration, Florida, USA. 3. 3 Department of Surgery, University of Auckland Faculty of Medicine and Health Sciences, Auckland, New Zealand.
Abstract
BACKGROUND: The indications, techniques, and outcomes for a minimally invasive surgical approach in oropharyngeal squamous cell carcinoma (OPSCC) unsuitable for transoral resection are not well-described. METHODS: A retrospective case series was performed using a prospectively assembled database of transoral surgery-treated OPSCC patients who also underwent a "hybrid" approach of combined transoral and limited pharyngotomy for tumor resection. Disease and functional outcomes were evaluated. RESULTS: Twenty patients underwent complete tumor resection using the hybrid approach. Median follow-up was 48 months. No postoperative pharyngocutaneous fistula occurred. One patient (5%) had a local recurrence. Kaplan-Meier estimates for disease-specific survival at 2 and 5 years were 94.4% (95% CI, 84%-100%) and 87% (95% CI, 70%-100%). All but 1 patient (due to chemoradiotherapy-related chondroradionecrosis) were decannulated, and 2 required long-term gastrostomy. CONCLUSION: In the absence of a favorable transoral access, the "hybrid" approach of combined transoral and limited pharyngotomy can accomplish margin-negative primary tumor resection, with a high degree of disease control and functional recovery in selected OPSCC patients.
BACKGROUND: The indications, techniques, and outcomes for a minimally invasive surgical approach in oropharyngeal squamous cell carcinoma (OPSCC) unsuitable for transoral resection are not well-described. METHODS: A retrospective case series was performed using a prospectively assembled database of transoral surgery-treated OPSCC patients who also underwent a "hybrid" approach of combined transoral and limited pharyngotomy for tumor resection. Disease and functional outcomes were evaluated. RESULTS: Twenty patients underwent complete tumor resection using the hybrid approach. Median follow-up was 48 months. No postoperative pharyngocutaneous fistula occurred. One patient (5%) had a local recurrence. Kaplan-Meier estimates for disease-specific survival at 2 and 5 years were 94.4% (95% CI, 84%-100%) and 87% (95% CI, 70%-100%). All but 1 patient (due to chemoradiotherapy-related chondroradionecrosis) were decannulated, and 2 required long-term gastrostomy. CONCLUSION: In the absence of a favorable transoral access, the "hybrid" approach of combined transoral and limited pharyngotomy can accomplish margin-negative primary tumor resection, with a high degree of disease control and functional recovery in selected OPSCC patients.
Authors: Hadi Seikaly; Vincent L Biron; Han Zhang; Daniel A O'Connell; David W J Côté; Khalid Ansari; David C Williams; Lakshmi Puttagunta; Jeffrey R Harris Journal: Head Neck Date: 2015-07-14 Impact factor: 3.147
Authors: Jennifer H Gross; Melanie Townsend; Helena Y Hong; Emily Miller; Dorina Kallogjeri; Joseph Zenga; Patrik Pipkorn; Ryan S Jackson; Bruce Haughey; Jason T Rich Journal: Laryngoscope Date: 2019-04-07 Impact factor: 3.325