Treatment of superficial carcinoma in hypopharynx

Superficial carcinoma of the esophagus is generally treated with endoscopic mucosal resection (EMR), yielding an acceptable prognosis and quality of life (QOL). With technical advances in endoscopy, it has become to possible to find superficial carcinoma even in the hypopharynx. Several reports suggest that such superficial carcinomas are treatable only with local mucosal resection. We treated 67 superficial carcinomas (49 cases) of the hypopharynx with local mucosal resection in our hospital, mainly with EMR. From 2004, we have resected 11 lesions directly with endoscopic assist (endoscopic laryngopharyngeal surgery; ELPS). With ELPS, it was very easy to recognize lugol-voiding lesions in the hypopharynx, and ELPS enabled us to do en bloc resection even for large lesions that could not be treated with EMR or with microscopic surgery. Eight of 49 cases had transient side effects-2 vocal cord palsies, 2 vocal cord edemas with overnight intubation, 3 overnight intubations, and 1 pharyngitis. Six patients died of other diseases, and no metastasis or recurrence of superficial carcinoma was found. Diagnosis and treatment of superficial carcinoma of the hypopharynx may thus improve patient prognosis and QOL.