Annual Report 2020
Department of Head and Neck Surgery
Seiichi Yoshimoto, Go Omura, Kenya Kobayashi, Yoshifumi Matsumoto, Atsuo Ikeda, Azusa Sakai, Akiko Ito, Kohtaro Eguchi, Tomonari Takano
Introduction
The treatment strategy for head and neck cancer is to improve the survival rates while preserving the significant functions, including speech, mastication, swallowing and cosmetic appearance. To achieve this strategy, our department has sought to select the best treatment modality and devise new surgical procedures based on clinical-pathological findings and our large database of patients with head and neck cancer.
Our department has developed and performed original surgical procedures for partial or subtotal laryngectomy for newly-diagnosed and radiation-failed 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 conventional surgery, there are apparently fewer wound complications. Patients can resume social activities more easily when they maintain their ability to communicate orally.
The Team and What We Do
The Department of Head and Neck Surgery at NCCH consists of 9 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.
We have many patients with extremely rare malignant diseases, such as head and neck sarcoma. There is therefore a need for greater collaboration with many departments and medical staff.
In 2020, 406 patients with head and neck tumors underwent surgery under general anesthesia, including 101 patients with major ablation and free-flap reconstructive surgery. Table 1 shows the number of surgical cases under general anesthesia.
Research activities
We are performing translational research in collaboration with the Department of Pathology, the Department of Head and Neck Medical Oncology, and research institutes.
Clinical trials
We are participating in a JCOG (Japanese Clinical Oncology Group) study on intra-arterial chemoradiotherapy for maxillary sinus cancer and a phase III study on END vs. watchful waiting for tongue cancer. In addition, several global clinical trials on immune checkpoint inhibitors are ongoing in our hospital.
Education
We provide plenty of educational opportunities for resident doctors, with particular focus on acquiring operative techniques. They can learn all about perioperative management, such as physical examination, image diagnosis, informed consent, preoperative preparation and postoperative management.
Future Prospects
Transoral resection for superficial laryngo-pharyngeal cancer will be indicated for more patients. Robotic surgery will soon be introduced in Japan. Treatment strategies for HPV-related oropharyngeal cancer will be discussed after analyzing clinical data and obtaining the results of clinical trials. Immune checkpoint inhibitors are employed for chemo-resistant patients with recurrent or metastatic tumors. We will obtain useful information on the response rate of these drugs for Japanese patients.
List of papers published in 2020
Journal
1. Matsumoto F, Miyakita Y, Sakai A, Akamatsu M, Matsumoto Y, Matsumura S, Omura G, Kobayashi K, Narita Y, Yoshimoto S. Resection of carcinoma of the external auditory canal in a patient with a high jugular bulb using temporal craniotomy. Auris Nasus Larynx, 48:535-538, 2021
2. Shiga K, Nibu KI, Fujimoto Y, Asakage T, Homma A, Mitani H, Ogawa T, Okami K, Murono S, Hirano S, Ueda T, Hanai N, Tsukahara K, Ota I, Yoshimoto S, Shinozaki T, Iwae S, Katagiri K, Saito D, Kiyota N, Tahara M, Takahashi F, Hayashi R. Multi-institutional Survey of Squamous Cell Carcinoma of the External Auditory Canal in Japan. Laryngoscope, 131:E870-E874, 2021
3. Hirose K, Konno A, Hiratsuka J, Yoshimoto S, Kato T, Ono K, Otsuki N, Hatazawa J, Tanaka H, Takayama K, Wada H, Suzuki M, Sato M, Yamaguchi H, Seto I, Ueki Y, Iketani S, Imai S, Nakamura T, Ono T, Endo H, Azami Y, Kikuchi Y, Murakami M, Takai Y. Boron neutron capture therapy using cyclotron-based epithermal neutron source and borofalan ((10)B) for recurrent or locally advanced head and neck cancer (JHN002): An open-label phase II trial. Radiother Oncol, 155:182-187, 2021
4. Kobayashi K, Yoshimoto S, Ando M, Matsumoto F, Murakami N, Omura G, Honma Y, Matsumoto Y, Ikeda A, Sakai A, Eguchi K, Ito A, Ryo E, Yatabe Y, Mori T. Full-coverage TP53 deep sequencing of recurrent head and neck squamous cell carcinoma facilitates prognostic assessment after recurrence. Oral Oncol, 113:105091, 2021
5. Ito A, Kobayashi K, Shiotsuka M, Sato T, Omura G, Matsumoto Y, Ikeda A, Sakai A, Eguchi K, Takano T, Matsumoto F, Kobayashi O, Iwata S, Yoshimoto S. Uniform infection screening allowed safe head and neck surgery during the coronavirus disease 2019 pandemic in Japan. Jpn J Clin Oncol, 51:400-407, 2021
6. Sano D, Shimizu A, Tateya I, Fujiwara K, Mori T, Miyamoto S, Nishikawa D, Terada T, Yasumatsu R, Ueda T, Matsumoto F, Kishimoto Y, Maruo T, Fujimoto Y, Tsukahara K, Yoshimoto S, Nibu KI, Oridate N. Treatment outcomes of transoral robotic and non-robotic surgeries to treat oropharyngeal, hypopharyngeal, and supraglottic squamous cell carcinoma: A multi-center retrospective observational study in Japan. Auris Nasus Larynx, 48:502-510, 2021
7. Suzuki M, Eguchi K. Metastasis to the lateral lingual lymph node located behind the submandibular gland: A case of squamous cell carcinoma of the tongue. Clin Case Rep, 9:1763-1766, 2021
8. Kobayashi K, Matsumoto F, Miyakita Y, Arikawa M, Omura G, Matsumura S, Ikeda A, Sakai A, Eguchi K, Narita Y, Akazawa S, Miyamoto S, Yoshimoto S. Risk Factors for Delayed Surgical Recovery and Massive Bleeding in Skull Base Surgery. Biomed Hub, 5:87-100, 2020
9. Matsumoto F, Kobayashi K, Omura G, Matsumura S, Matsumoto Y, Fukasawa M, Yoshimoto S. Pull-through resection without free-flap reconstruction for lateral wall oropharyngeal cancer. Jpn J Clin Oncol, 50:1018-1022, 2020
10. Matsuzuka T, Uemura H, Yoshimoto S, Miura K, Shiotani A, Sugasawa M, Homma A, Yokoyama J, Tsukahara K, Yoshizaki T, Yatabe Y, Kobari T, Kosuda S, Murono S, Hasegawa Y. Attempting to define sentinel node micrometastasis in oral squamous cell carcinoma. Fukushima J Med Sci, 66:143-147, 2020
11. Saito Y, Hayashi R, Iida Y, Mizumachi T, Fujii T, Matsumoto F, Beppu T, Yoshida M, Shinomiya H, Kamiyama R, Kitano M, Yokoshima K, Fujimoto Y, Hama T, Yamashita T, Okami K, Miura K, Fujisawa T, Sano D, Kato H, Minami S, Sugasawa M, Masuda M, Ota I, Iwae S, Kawata R, Monden N, Imai T, Asakage T, Okada M, Yoshikawa T, Tanioka K, Kitayama M, Doi M, Fujii S, Fujii M, Oridate N, Nakamizo M, Yoshimoto S, Homma A, Nibu KI, Yane K. Optimization of therapeutic strategy for p16-positive oropharyngeal squamous cell carcinoma: Multi-institutional observational study based on the national Head and Neck Cancer Registry of Japan. Cancer, 126:4177-4187, 2020