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Lateral pharyngotomy for selected invasive squamous cell carcinoma of the lateral oropharynx. Part II: When and why
Author(s) -
Laccourreye Ollivier,
Benito José,
Garcia Dominique,
Menard Madeleine,
Bonfils Pierre,
Holsinger Christopher
Publication year - 2013
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.24246
Subject(s) - medicine , neck dissection , retrospective cohort study , surgery , radiation therapy , dissection (medical) , basal cell , cohort , carcinoma , chemotherapy
Objectives/Hypothesis To analyze local failure following lateral pharyngotomy for selected untreated invasive squamous cell carcinoma (SCC) of the lateral oropharynx. Study Design Retrospective review from a university teaching hospital. Methods Inception cohort of 91 patients who underwent lateral pharyngotomy for an isolated and previously untreated selected invasive carcinoma of the lateral oropharynx classified as T1 (26), T2 (47), T3 (11), and T4 (7). Induction chemotherapy, neck dissection, and postoperative radiation therapy were used in 91.2%, 94.5%, and 53.5% of patients. Results The 5‐year Kaplan‐Meier estimate of local failure was 16.6% for T1, 19% for T2, 38.6% for T3, and 16.7% for T4 lesions ( P = .46). In a logistic regression model, only positive margins of resection statistically increased ( P = .01) the risk for local failure. In patients with safe margins of resection, the 5‐year Kaplan‐Meier estimate of local failure was 5.6% for T1 lesions, 10.7% for T2 lesions, 23.8% for T3 lesions, and 20% for T4 lesions ( P = .4). Local failure had a significant impact on increased nodal failure ( P = .001) and on reduced survival ( P < .0001). Conclusion The lateral pharyngotomy approach should be viewed as a valuable oncologic alternative to both mandibulotomy and chemoradiation in patients with selected SCC of the lateral oropharynx. Level of Evidence 4. Laryngoscope , 123:2718–2722, 2013