This article is more than 5 years old. Information may no longer be current.
ESD shows promise for treatment of superficial pharyngeal cancer
Click Here to Manage Email Alerts
Endoscopic submucosal dissection appears safe and effective for treating patients with superficial pharyngeal cancer, according to results from a phase 2 study.
“Endoscopic treatments such as [endoscopic mucosal resection] and [endoscopic submucosal dissection] have been applied as minimally invasive treatments for superficial pharyngeal cancer,” the researchers wrote. “[Endoscopic submucosal dissection] has been reported to obtain higher rates of complete resection … than does [endoscopic submucosal resection], but [endoscopic submucosal dissection] is technically difficult and time consuming. Because these studies were retrospective, and prospective studies have not been reported, we prospectively assessed the efficacy and safety of [endoscopic submucosal dissection] for superficial pharyngeal cancer.”
Between September 2010 and August 2014, 54 mostly male patients who collectively had 73 lesions (stage 0, n = 22; stage 1, n = 14; stage 2, n = 17; stage 3, n = 1) underwent endoscopic submucosal dissection (ESD) performed by one of two endoscopists who had performed more than 100 GI tract ESD procedures. Median follow-up was 27 months (range, 6-55 months). Complete resection rate served as the primary endpoint.
En bloc resection was achieved for all lesions, and complete resection was achieved for 79.5% (95% CI, 68%-88%) of lesions.
“This rejects the null hypothesis of a threshold complete resection rate of 60%,” the researchers wrote.
No procedure-related serious adverse events occurred, no patients required percutaneous endoscopic gastrostomy or tracheotomy, all patients had preserved swallowing, speech and airway functions, four patients required nasogastric tube feeding and one patient died of an unrelated illness. Local cervical lymph node metastasis occurred in one patient, which was treated successfully with lymph node dissection.
The 3-year overall survival rate was 97.7% and the 3-year recurrence-free survival rate was 98.1%. Three-year cumulative development of multiple cancers of the pharynx was 18.4%.
“We confirmed that ESD is an oncologically safe and function-preserving technique,” the researchers concluded. “ESD provides a novel, minimally invasive, surgical alternative for pharyngeal cancer in hospitals with endoscopists who are experts in performing ESD for patients with GI tract cancers.” – by Adam Leitenberger
Disclosures: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts