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国立がん研究センター 中央病院

Home > Clincal depts. > Department of Head and Neck Oncology

Department of Head and Neck Oncology

Seiichi Yoshimoto, Fumihiko Matsumoto, Kenya Kobayashi, Daisuke Maki, Masanori Teshima, Masahiko Fukazawa

Introduction

The treatment strategy for head and neck cancer is to improve survival rates while preserving the significant functions including speech, mastication, swallowing and cosmetic appearance. In order to achieve this strategy, our department has tried to select the best treatment modality and devise new surgical procedures based on clinicpathological findings and our large database of patients with head and neck cancer.

Our department has developed and performed original surgical procedures of partial or subtotal laryngectomy for newly diagnosed and radiationfailed laryngeal cancer, partial pharyngectomy for hypopharyngeal cancer and total glossectomy for advanced tongue cancer. These surgical approaches can be performed without sacrificing the larynx. Compared with the results of conventional surgery, there are apparently fewer wound complications. Patients can resume social activities more easily when they maintain their ability to communicate vocally.

Routine activities

The Department of Head and Neck Oncology at NCCH consists of six head and neck surgeons. Many operations are performed under general and local anesthesia with or without microsurgical reconstructive surgery. In addition to radiotherapy, concurrent chemo-radiotherapy is performed with the Department of Radiation Oncology.

In 2015, 403 patients with head and neck tumor underwent surgery under local or general anesthesia: 127 and 276, respectively, including 78 patients with major ablation and reconstructive surgery. Table 1 shows the number of surgical cases with each primary site. Table 2 shows the number of each surgical procedure.

Research activities

We have been taking part in multi-institutional studies of sentinel lymph node navigation surgery for oral cavity cancer using RI and laryngopharyngeal cancer using ICG. We are also taking part in a multi-institutional study of intra-arterial chemo-radiotherapy for maxillary cancer.

Clinical trials

We are participating in a few clinical trials about immune checkpoint inhibitors.

Education

We provide plenty of educational opportunities for resident doctors, especially focusing on acquiring operative techniques. They can learn everything about perioperative management, such as physical examination, image diagnosis, informed consent, preoperative preparation and postoperative management.

Future Prospects

We have recently started trans-oral resection for superficial laryngopharyngeal cancer. Transoral resection will be indicated for more patients. Cetuximab is used for many patients with recurrent or metastatic tumors. We will be able to get useful information about the response rate of Cetuximab for Japanese patients. The number of patients with HPV-related oropharyngeal cancer has increased. The treatment strategy for this disease should be discussed.


Table 1. Number of patients Table 2. Type of procedure

List of papers published in 2015

Journal

  1. Murakami N, Yoshimoto S, Matsumoto F, Ueno T, Ito Y, Watanabe S, Kobayashi K, Harada K, Kitaguchi M, Sekii S, Takahashi K, Yoshio K, Inaba K, Morota M, Sumi M, Saito Y, Itami J. Severe gastrointestinal bleeding in patients with locally advanced head and neck squamous cell carcinoma treated by concurrent radiotherapy and Cetuximab. J Cancer Res Clin Oncol, 141:177-184, 2015
  2. Kinjo Y, Nonaka S, Oda I, Abe S, Suzuki H, Yoshinaga S, Maki D, Yoshimoto S, Taniguchi H, Saito Y. The short-term and longterm outcomes of the endoscopic resection for the superficial pharyngeal squamous cell carcinoma. Endosc Int Open, 3:E266-E273, 2015
  3. Wakisaka N, Hasegawa Y, Yoshimoto S, Miura K, Shiotani A, Yokoyama J, Sugasawa M, Moriyama-Kita M, Endo K, Yoshizaki T. Primary Tumor-Secreted Lymphangiogenic Factors Induce Pre-Metastatic Lymphvascular Niche Formation at Sentinel Lymph Nodes in Oral Squamous Cell Carcinoma. PLoS One, 10:e0144056, 2015
  4. Kobayashi K, Ando M, Saito Y, Kondo K, Omura G, Shinozaki- Ushiku A, Fukayama M, Asakage T, Yamasoba T. Nerve Growth Factor Signals as Possible Pathogenic Biomarkers for Perineural Invasion in Adenoid Cystic Carcinoma. Otolaryngol Head Neck Surg, 153:218-224, 2015