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Efficacy of endoscopic surveillance for pharyngeal mucosa during endoscopic resection for pharyngeal carcinoma: a multicenter prospective study

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Abstract

Introduction

Since patients with pharyngeal squamous cell carcinoma (SCC) often have multiple pharyngeal lesions, evaluation of pharyngeal lesions before endoscopic resection (ER) is important. However, detailed endoscopic observation of the entire pharyngeal mucosa under conscious sedation is difficult. We examined the usefulness of endoscopic surveillance with narrow band imaging (NBI) and lugol staining for detection of pharyngeal sublesions during ER for pharyngeal SCC under general anesthesia (endoscopic surveillance during treatment; ESDT).

Methods

From January 2021 through June 2022, we examined 78 patients who were diagnosed with superficial pharyngeal SCC and underwent ER. They underwent the ESDT and for patients who were diagnosed with new lesions of pharyngeal SCC or high-grade dysplasia (HGD) that were not detected in the endoscopic examination before treatment, ER were performed simultaneously for new lesions and the main lesions. The primary endpoint of this study was the detection rate of new lesions of pharyngeal SCC or HGD in the ESDT.

Results

Fifteen of the 78 patients were diagnosed as having undetected new pharyngeal lesions in the ESDT and 10 (12.8%) (95% CI 6.9–22.2%) were histopathologically confirmed to have new lesions of pharyngeal SCC or HGD. Among the 13 lesions of SCC or HGD, 8 were found by NBI observation; however, 5 were undetectable using NBI but detectable by lugol staining. All of the 13 lesions had endoscopic findings of pink color sign on lugol staining.

Conclusions

Endoscopic surveillance for pharyngeal sublesions during ER for pharyngeal SCC is feasible and useful.

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Authors and Affiliations

  1. Department of Otolaryngology Head and Neck Surgery, Keiyukai Sapporo Hospital, Sapporo, Hokkaido, Japan

    Yuki Kimura, Masanobu Taniguchi, Suguru Ito & Akihito Watanabe

  2. Department of Gastroenterology, National Hospital Organization, Hokkaido Medical Center, 5-7, Yamanote, Nishi-ku, Sapporo, Hokkaido, 063-0005, Japan

    Yuichi Shimizu

  3. Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan

    Akira Dobashi

  4. Department of Gastroenterology, Dokkyo Medical University, Mibu, Tochigi, Japan

    Kenichi Goda

  5. Division of Endoscopy, Hokkaido University Hospital, Sapporo, Hokkaido, Japan

    Yusuke Nishimura & Keiko Yamamoto

  6. Department of Surgical Pathology, Sapporo Kosei General Hospital, Sapporo, Hokkaido, Japan

    Shin Ichihara

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  1. Yuki Kimura
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Contributions

YK, YS and AW contributed to conception and design, MT, SI, AD, KG, YN and KY contributed to collection and analysis of the data, SI performed histopathological diagnosis.

Corresponding author

Correspondence to Yuichi Shimizu.

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Disclosures

Yuki Kimura, Yuichi Shimizu, Masanobu Taniguchi, Suguru Ito, Akira Dobashi, Kenichi Goda, Yusuke Nishimura, Keiko Yamamoto, Shin Ichihara and Akihito Watanabe declare that they have no conflicts of interest or financial ties to disclose.

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Kimura, Y., Shimizu, Y., Taniguchi, M. et al. Efficacy of endoscopic surveillance for pharyngeal mucosa during endoscopic resection for pharyngeal carcinoma: a multicenter prospective study. Surg Endosc (2024). https://doi.org/10.1007/s00464-024-10747-5

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