하인두암의 경구강 레이저 수술
Transoral Carbon-Dioxide Laser Microsurgery in Hypopharyngeal Carcinoma
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Background and Objectives：Recently, organ-preserving transoral CO_2 laser surgery have been introduced for hypopharyngeal cancer. The aim of this study was to define when CO_2 laser surgery of hypopharyngeal cancer is indicated and to evaluate the oncologic local control rate, functional results, and postoperative complications. Subjects and Method：A retrospective review of 6 patients undergoing transoral CO_2 laser microsurgery for the treatment of squamous cell carcinomas of the hypopharynx involving posterior pharyngeal wall (2 patients), pyriform sinus (4 patients) from May 2006 to December 2010 was undertaken. There were three patients with staging T3, underwent transoral CO_2 laser surgery to remove residual cancer after the induction chemotherapy. The median follow-up interval was 32 months. Results：Five out of six cases showed no local recurrence. One patient with pyriform sinus cancer died with the local recurrence and lymph node metastasis, and local control rate during follow up was 83.3%. One patient died due to brain metastasis in the postoperative 24 months, other patient died due to second primary esophageal cancer in the postoperative 36 months. There were 2 cases of surgical complications; dysphagia due to temporary esophageal stricture and primary site’s bleeding. Conclusions：Although more number of cases and time are needed, in some carefully selected cases of the early staging and advanced hypopharyngeal cancer after induction chemotherapy, transoral CO_2 laser surgery can be one of the choice.
Abstract
Background and Objectives：Recently, organ-preserving transoral CO_2 laser surgery have been introduced for hypopharyngeal cancer. The aim of this study was to define when CO_2 laser surgery of hypopharyngeal cancer is indicated and to evaluate the oncologic local control rate, functional results, and postoperative complications. Subjects and Method：A retrospective review of 6 patients undergoing transoral CO_2 laser microsurgery for the treatment of squamous cell carcinomas of the hypopharynx involving posterior pharyngeal wall (2 patients), pyriform sinus (4 patients) from May 2006 to December 2010 was undertaken. There were three patients with staging T3, underwent transoral CO_2 laser surgery to remove residual cancer after the induction chemotherapy. The median follow-up interval was 32 months. Results：Five out of six cases showed no local recurrence. One patient with pyriform sinus cancer died with the local recurrence and lymph node metastasis, and local control rate during follow up was 83.3%. One patient died due to brain metastasis in the postoperative 24 months, other patient died due to second primary esophageal cancer in the postoperative 36 months. There were 2 cases of surgical complications; dysphagia due to temporary esophageal stricture and primary site’s bleeding. Conclusions：Although more number of cases and time are needed, in some carefully selected cases of the early staging and advanced hypopharyngeal cancer after induction chemotherapy, transoral CO_2 laser surgery can be one of the choice.
참고문헌 (19)
- Hoffman HT, "Hypopharyngeal cancer patient care evaluation", Laryngoscope, 107(8), pp.1005~1017 (1997)
- Wolf GT, "Workshop report: organ preservation strategies in advanced head and neck cancer: current status and future directions", Head Neck, 21(8), pp.689~693 (1999)
- Eckel HE, "Surgical treatment for hypopharynx carcinoma: feasibility, mortality, and results", Otolaryngol Head Neck Surg, 124(5), pp.561~569 (2001)
- Krespi YP, "Voice preservation in pyriform sinus carcinoma by hemicricolaryngopharyngectomy", Ann Otol Rhinol Laryngol, 93, pp.306~310 (1984)
- Clayman GL, "Laryngeal preservation for advanced laryngeal and hypopharyngeal cancers", Arch Otolaryngol Head Neck Surg, 121(2), pp.219~223 (1995)
- Zeitels SM, "Endoscopic treatment of supraglottis and hypopharynx cancer", Laryngoscope, 104, pp.71~78 (1994)
- Steiner W, "Endoscopic laser surgery of the upper aerodigestive tract: with special emphasis on cancer surgery. 1st ed", pp.2~10 (2000), George Thieme Verlag
- Ogura JH, "Partial laryngopharyngectomy and neck dissection for pyriform sinus cancer. Conservation surgery with immediate reconstruction", Laryngoscope, 70, pp.1399~1417 (1960)
- Lefebvre JL, "What is the role of primary surgery in the treatment of laryngeal and hypopharyngeal cancer?: Hayes martin lecture", Arch Otolaryngol Head Neck Surg, 126(3), pp.285~288 (2000)
- Laccourreye O, "Supracricoid hemilaryngopharyngectomy in selected pyriform sinus carcinoma staged as T2", Laryngoscope, 103(12), pp.1373~1379 (1993)
- Beauvillain C, "Final results of a randomized trial comparing chemotherapy plus radiotherapy with chemotherapy plus surgery plus radiotherapy in locally advanced resectable hypopharyngeal carcinomas", Laryngoscope, 107(5), pp.648~653 (1997)
- Lecanu JB, "Conservative surgery in T3-T4 pharyngolaryngeal squamous cell carcinoma: an alternative to radiation therapy and to total laryngectomy for good responders to induction chemotherapy", Laryngoscope, 110, pp.412~416 (2000)
- Urba SG, "Neoadjuvant therapy for organ preservation in head and neck cancer", Laryngoscope, 110(12), pp.2074~2080 (2000)
- Rudert HH, "Transoral carbon-dioxide laser resection of hypopharyngeal carcinoma", Eur Arch Otorhinolaryngol, 260(4), pp.198~206 (2003)
- Steiner W, "Organ preservation by transoral laser microsurgery in piriform sinus carcinoma", Otolaryngol Head Neck Surg, 124(1), pp.58~67 (2001)
- Vilaseca I, "CO2 laser surgery: a larynx preservation alternative for selected hypopharyngeal carcinomas", Head Neck, 26(11), pp.953~959 (2004)
- Weichselbaum RR, "Molecular targets to overcome radioresistance", Semin Oncol, 19(4), pp.14~20 (1992)
- Shiga H, "Prognostic value of c-erbB2 and other markers in patients treated with chemotherapy for recurrent head and neck cancer", Head Neck, 22(6), pp.599~608 (2000)
- Bernal-Sprekelsen M, "Predictive values for aspiration after endoscopic laser resections of malignant tumors of the hypopharynx and larynx", Head Neck, 26(2), pp.103~110 (2004)