内镜黏膜下剥离术与经口视频喉镜手术治疗表浅下咽癌的临床结局
Clinical Outcomes of Endoscopic Submucosal Dissection and Transoral Videolaryngoscopic Surgery for Superficial Hypopharyngeal Cancers.
文献信息
| PMID | 42825312 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Tomoko Ochiai |
| 作者单位 | Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. |
| 期刊 | Journal of gastroenterology and hepatology |
| SCI 分区 | Q2 |
| IF | 3.8 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 包括经口视频喉镜手术（TOVS）和内镜黏膜下剥离术（ESD）在内的表浅咽癌微创治疗作为微创治疗手段已越来越广泛；然而，尚无研究报告比较这些治疗方法。
方法： 我们回顾性研究了2013年1月至2024年12月期间接受ESD或TOVS的连续表浅下咽鳞状细胞癌患者。
结果： 共有55例患者的60个病灶纳入ESD组和TOVS组。两组的整块切除率均为100%。ESD组的R0切除率显示出高于TOVS组的非显著趋势（58.1% vs. 34.5%；p = 0.077）。TOVS组与ESD组的3年总生存（OS）率未观察到显著差异（93.8% vs. 81.3%；p = 0.330）。TOVS组的3年局部复发累积发生率为13.6%，ESD组为5.9%（p = 0.241）。在一项探索性单变量分析中，肿瘤厚度≥1000 μm与淋巴结转移显著相关（p = 0.017）。
结论： 表浅下咽癌患者在ESD与TOVS之间的临床结局无显著差异。尽管ESD后的局部复发累积发生率在数值上低于TOVS后，但差异无统计学意义。对于选定的患者，这两种手术可能都是可行的微创治疗选择。
英文摘要
BACKGROUND: Minimally invasive treatments for superficial pharyngeal cancer including transoral videolaryngoscopic surgery (TOVS) and endoscopic submucosal dissection (ESD) have become more widespread as minimally invasive treatments; however, no reports have compared these treatment methods.
METHODS: We retrospectively investigated consecutive patients with superficial hypopharyngeal squamous cell carcinoma who underwent ESD or TOVS between January 2013 and December 2024.
RESULTS: A total of 60 lesions in 55 patients were included in the ESD and TOVS groups. The en bloc resection rate was 100% in both groups. The R0 resection rate in the ESD group showed a nonsignificant trend toward being higher than that in the TOVS group (58.1% vs. 34.5%; p = 0.077). No significant differences were observed in the 3-year overall survival (OS) rates between the TOVS and ESD groups (93.8% vs. 81.3%; p = 0.330). The 3-year cumulative incidence of local recurrence was 13.6% in the TOVS group and 5.9% in the ESD group (p = 0.241). In an exploratory univariate analysis, tumor thickness ≥ 1000 μm was significantly associated with lymph node metastasis (p = 0.017).
CONCLUSIONS: Clinical outcomes in patients with superficial hypopharyngeal cancer were not significantly different between ESD and TOVS. Although the cumulative incidence of local recurrence was numerically lower after ESD than after TOVS, the difference was not statistically significant. Both procedures may represent feasible minimally invasive treatment options for selected patients.