Endoscopic treatment for superficial squamous cell carcinoma in the head and neck region (HNSCC)

Abstract

16542 Background: The HNSCC are usually diagnosed at advanced stage, therefore, the prognosis is dismal. Recently we can find the superficial HNSCC by using high-resolution and magnifying endoscopy. We expect to get a good prognosis by the endscopic treatment (EMRC: Endoscopic Mucosal Resection by Cap-method/ELPS: Endoscopic Laryngo-Pharyngeal Surgery) for the superficial HNSCC. The purpose of this study is to examine the usefulness and effectiveness of endoscopic treatment for the superficial HNSCC. Methods: The superficial HNSCC means that the depth of cancer invasion is within the subepithelial layer. When we diagnose superficial HNSCC with no lymphnode metastasis, the endoscopic treatment (EMRC/ELPS) becomes the first line treatment under general-anesthesia. For those treatment cases, We examine the method of treatment, complication, pathological diagnosis and prognsis. Result: We have 130 patients (201 lesions) of the superficial HNSCC from Jan 2000 to Jan 2007. The endoscopic treatment cases were 92 (142 lesions), 87 male and 5 female, ranging in age from 40 to 86 years. Of the 92 patients, 56 (60.9%) had been treated by EMRC, 36 (39.1%) had been treated by ELPS. EMRC is good for small lesion (less than 10 mm in diameter). ELPS is suitable for large lesion. In EMRC case, a wound pain was often slight after the operation, and patient could leave the hospital in 4–5POD. In ELPS case, a wound pain was stronger than EMRC, and needed more hospital days. Major complication was not recognized both in EMRC and ELPS. Of 142 lesions which clinical assessments of the depth of cancer invasion were ep (epithelial layer) or sep (subepithlial layer), 140 lesions (98.6%) were histopathologically ep or sep. Two lesions (1.4%) were mp (proper muscular layer). Of the 92 patients, 83 are alive, 9 had been dead. There was no lymphnode metastasis, distant metastasis and local recurrent case. Forty patients of 3 years observation were accrued from Jan 2000 to Dec 2003. Of the 40 patients, 33 were alive, 7 were dead. No HNSCC patients died. The cause specific 3 years survival rate is 100%. Conclusion: The result of our trial indicated the usefulness of endoscopic treatment for superficial HNSCC and the effectiveness for improving the prognosis of HNSCC No significant financial relationships to disclose.