Comparison of salvage and planned pharyngolaryngectomy with jejunal transfer for hypopharyngeal carcinoma after chemoradiotherapy

Hideki Kadota, Junichi Fukushima, Torahiko Nakashima, Yoshihiko Kumamoto, Sei Yoshida, Ryuji Yasumatsu, Hideki Shiratsuchi, Masaru Morita, Shizuo Komume

研究成果: Contribution to journalArticle査読

33 被引用数 (Scopus)

抄録

Objectives/Hypothesis: Salvage surgery after definitive chemoradiotherapy is often associated with a higher rate of perioperative complications and poor prognosis. The objective of this study is to examine the safety and efficacy of free jejunal transfer after salvage pharyngolaryngectomy for patients with locally recurrent hypopharyngeal carcinoma after definitive chemoradiotherapy. Study Design: A retrospective analysis of patients with advanced hypopharyngeal carcinoma who underwent pharyngolaryngectomy and reconstruction using free jejunum. Methods: Forty patients who underwent pharyngolaryngectomy with jejunal transfer were included in this study. Fourteen patients underwent surgery after definitive chemoradiotherapy (the salvage-surgery group), whereas 26 patients underwent surgery after planned preoperative chemoradiotherapy (the planned-surgery group). The perioperative conditions, mortality, morbidity, functional outcomes, and oncologic outcomes in each group were compared. Results: The patients in the salvage-surgery group lost an average of 9 kg in weight before surgery, which thus indicated a malnourished condition. However, the incidence of all perioperative complications did not differ significantly between the groups. All patients in both groups achieved oral intake without tube feeding, and the intervals to start oral intake were 12.8 days in the salvage-surgery group and 15.6 days in the planned-surgery group, which was not significantly different. The 5-year diseasefree survival was 57.1% in the salvage-surgery group and 50.4% in the planned-surgery group, which was not significantly different. Conclusions: Salvage pharyngolaryngectomy and jejunal transfer can be performed safely and reliably for patients with locally recurrent hypopharyngeal carcinoma, and it is an excellent option after a failure of definitive chemoradiotherapy.

本文言語英語
ページ(範囲)1103-1108
ページ数6
ジャーナルLaryngoscope
120
6
DOI
出版ステータス出版済み - 6 2009

All Science Journal Classification (ASJC) codes

  • 耳鼻咽喉科学

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