The Hybrid Transoral-Pharyngotomy Approach to Oropharyngeal Carcinoma.

The Hybrid Transoral-Pharyngotomy Approach to Oropharyngeal Carcinoma.

Ann Otol Rhinol Laryngol. 2017 Feb 01;:3489417691297

Authors: Sinha P, Pipkorn P, Zenga J, Haughey BH

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.

PMID: 28205447 [PubMed - as supplied by publisher]

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