Endoscopic submucosal dissection for treatment of early stage hypopharyngeal carcinoma

BackgroundEarly detection of hypopharyngeal carcinoma is increasingly possible and patients with such early lesions can be treated with endoscopic resection.ObjectiveTo identify the optimal relationship between the mucosal defect of the hypopharynx and malfunction of the hypopharynx after endoscopic resection of early hypopharyngeal carcinoma.DesignCase series.SettingReferral center in Japan.PatientsFour patients with early-stage squamous cell carcinoma of the hypopharynx underwent endoscopic submucosal dissection (ESD). By using ESD, an accurate incision line close to the tumor margin could be confirmed while performing treatment. ESD was performed with a small-caliber-tip transparent hood (ST-hood) to open the incision line for better visualization of the submucosa.Main Outcome MeasurementsFeasibility of en bloc resection, complications, and recurrence after ESD.ResultsNo early or late complications due to treatment occurred in the patients. Histological examination of resected specimens revealed that 2 patients had carcinoma in situ and 2 patients had tumor invasion of the subepithelium. There was no local recurrence or distant metastasis in any of the patients during the follow-up period (3-14 months).ConclusionsWe consider that ESD is the optimal method for endoscopic resection not only because it enables an en bloc resected specimen to be obtained but also because it can prevent removal of excess mucosa of the hypopharynx, which is a very narrow and important organ related to swallowing and speech.