Annual Report 2022

Department of Head and Neck Surgery

Kazuto Matsuura, Takeshi Shinozaki, Toshifumi Tomioka, Wataru Okano, Yukio Nishiya, Ryuichi Hayashi, Yusuke Itoh, Hideki Tanaka, Masanobu Sato, Hiroshi Idogawa, Koutarou Maeda, Daisuke Baba, Takuya Yamamoto, Yuki Harada

Introduction

 A feature of the clinical practice in our department is the development of function-preserving surgery. We are also actively introducing advanced surgery. Typical procedures include the following:

• Laryngeal preservation surgery for laryngeal cancer and hypopharyngeal cancer
• Development of regional neck dissection in salvage surgery
• Endoscopic laryngopharyngeal surgery (ELPS)
• Video-assisted neck surgery (VANS)
• Torans-oral Robotic surgery (TORS)
• Photoimmunotherapy (PIT)

 There are more cases in which the larynx is preserved during laryngeal and hypopharyngeal cancer surgery in our department compared with other institutions. Minimally invasive surgery using endoscopes or robots is often performed. The number of cases by site and surgical methods are shown in Tables 1 and 2 (some overlap).

The Team and What We Do

 Multimodal therapy is the current treatment policy for head and neck cancer. To effectively implement available therapeutic modalities, five staff surgeons at our department work closely with plastic surgeons, radiotherapists, medical oncologists, pathologists, dentists, psycho-oncologists, and nurses. To facilitate regular communication among the members of this large team, several weekly conferences are conducted.

 From April 2022 to March 2023, the number of operations was 490 cases. Particularly, 90 cases of endoscopic laryngopharyngeal surgery (ELPS), 69 cases underwent free flap reconstruction, 15 cases of endoscopic thyroid surgery and 6 cases of photoimmunotherapy were performed (Tables 1, 2).

Research Activities

 For the development of devices for head and neck endoscopic surgery, a hemostatic clip applier was developed and tested in clinical practice.

 The preoperative functional assessment of elderly patients with head and neck cancer indicated that patients who were more dependent on family members and who underwent laryngectomy or gastrostomy were more likely to be discharged to non-home care.

 A multicenter study of the Enhanced Recovery After Surgery (ERAS) program for reconstructive surgery for head and neck cancer (PreSte-HN study: J-SUPPORT2002) was accepted for an AMED study (21ck0106674h0001), and the number of cases is increasing at a faster pace than anticipated.

Clinical Trials

 Registration for the PreSte-HN study (Principal Investigator: Kazuto Matsuura, described in the previous section) is progressing smoothly.

 Enrollment in the TOS-J2 study (Principal investigator: Ryuichi Hayashi, Phase II/III study of oral surgery for superficial head and neck cancer in Japan) is underway.

 JCOG1601 is a randomized phase III trial evaluating the value of omitting prophylactic neck dissection for stage I/II tongue cancer, and enrollment is ongoing.

 JCOG1912 (Randomized Controlled Trial of Dose Reduction of Prophylactic Field Radiation in Chemoradiotherapy for Head and Neck Cancer) is also ongoing.

Education

 One senior resident and two junior residents were accepted for training. Additionally, one resident was certified as a head and neck cancer specialist. We also accepted a short-term visitor (Shinshu University) for 3 months. The number of domestic visitors was 13, and the number of foreign visitors accepted in 2022 was zero.

Future Prospects

 Head and neck cancer treatment has entered a new era of multidisciplinary treatment, with improvements in surgical techniques, innovations in radiotherapy, and drug therapy, as well as the recognition of the importance of supportive care for the completion of treatment. In addition, the number of elderly patients with head and neck cancer is increasing, which poses a major challenge to medical care. Although a smooth collaboration among related departments has been established, we would like to also provide telemedicine in the future. In terms of surgical techniques, we intend to develop minimally invasive, function-preserving neck surgery using endoscopes.

List of papers published in 2022

Journal

1. Omura G, Honma Y, Matsumoto Y, Shinozaki T, Itoyama M, Eguchi K, Sakai T, Yokoyama K, Watanabe T, Ohara A, Kato K, Yoshimoto S. Transnasal photoimmunotherapy with cetuximab sarotalocan sodium: Outcomes on the local recurrence of nasopharyngeal squamous cell carcinoma. Auris, nasus, larynx, 50:641-645, 2023

2. Morishita Y, Sakashita S, Tomioka T, Okano W, Shinozaki T, Higashino T, Matsuura K, Hayashi R. Human papillomavirus-related multiphenotypic sinonasal carcinoma. Auris, nasus, larynx, 50:151-155, 2023

3. Harada Y, Matsuki T, Miyamoto S, Kano K, Tsutsumi S, Momiyama K, Yamashita T. Total laryngectomy increases the risk of chronic constipation: a cross-sectional study of 50 patients. European archives of oto-rhino-laryngology, 280:419-423, 2023

4. Sakai M, Nishimura B, Hiyama T, Kuno H, Shinozaki T, Sakamoto N, Nakajima T. Imaging of diffuse fibroepithelial polyps on surgical free flap in oral cancer patients: two case reports. Neuroradiology, 65:815-818, 2023

5. Tomioka T, Beppu T, Onitsuka T, Fujimoto Y, Kawabata K, Matsuura K, Fujii T, Hayashi R, Asakage T. Post-operative progress of arm abduction function and rate of lymph node metastasis around the region of the accessory nerve: a multicentre prospective observational study. Japanese journal of clinical oncology, 53:401-409, 2023

6. Kondo T, Tsukahara K, Kawakita D, Yoshimoto S, Miura K, Sugasawa M, Chikamatsu K, Matsuzuka T, Oze I, Kitamura M, Murakami Y, Otozai S, Shinozaki T, Ohba S, Araki K, Mizumachi T, Sato D, Wakisaka N, Hirakawa H, Hasegawa Y. Macroscopic and multiple metastases in sentinel lymph node biopsy are respectively associated with poor prognosis in early oral cancer. International journal of clinical oncology, 28:512-520, 2023

7. Imamura Y, Kiyota N, Tahara M, Hanai N, Asakage T, Matsuura K, Ota I, Saito Y, Sano D, Kodaira T, Motegi A, Yasuda K, Takahashi S, Yokota T, Okano S, Tanaka K, Onoe T, Ariizumi Y, Homma A. Systemic therapy for salivary gland malignancy: current status and future perspectives. Japanese journal of clinical oncology, 52:293-302, 2022

8. Ishii R, Ohkoshi A, Kiyota N, Matsuura K, Yasuda K, Imamura Y, Saito Y, Homma A. Management of elderly patients with head and neck cancer. Japanese journal of clinical oncology, 52:313-321, 2022

9. Fujii K, Morita S, Mochizuki M, Shibuya-Takahashi R, Fujimori H, Yamaguchi K, Abe J, Yamazaki T, Imai T, Sugamura K, Yasuda J, Satoh K, Sato I, Saito-Koyama R, Fujishima F, Sasano H, Kato Y, Matsuura K, Asada Y, Tamai K. Establishment of a monoclonal antibody against glycosylated CD271 specific for cancer cells in immunohistochemistry. Cancer science, 113:2878-2887, 2022 

10. Adachi M, Tomioka T, Fujii S, Morishita Y, Okano W, Shinozaki T, Matsuura K, Hayashi R. Is elective neck dissection necessary for patients with cT3-4N0 parotid gland cancer? Auris, nasus, larynx, 49:856-861, 2022

11. Nakajo K, Inaba A, Aoyama N, Takashima K, Kadota T, Yoda Y, Morishita Y, Okano W, Tomioka T, Shinozaki T, Matsuura K, Hayashi R, Akimoto T, Yano T. The characteristics of missed pharyngeal and laryngeal cancers at gastrointestinal endoscopy. Japanese journal of clinical oncology, 52:575-582, 2022

12. Saito Y, Homma A, Kiyota N, Tahara M, Hanai N, Asakage T, Matsuura K, Ota I, Yokota T, Sano D, Kodaira T, Motegi A, Yasuda K, Takahashi S, Tanaka K, Onoe T, Okano S, Imamura Y, Ariizumi Y, Hayashi R. Human papillomavirus-related oropharyngeal carcinoma. Japanese journal of clinical oncology, 52:700-706, 2022

13. Imai T, Asada Y, Matsumoto K, Sato I, Goto T, Matsuura K. Neck dissection with carotid artery resection after insertion of a protective endovascular covered stent for recurrent head and neck cancer: a case report. International cancer conference journal, 11:119-123, 2022

14. Baba D, Matsuura K, Wakabayashi M, Morishita Y, Nishiya Y, Okano W, Tomioka T, Shinozaki T, Hayashi R. Comparison between three age-stratified cohorts reveals poor prognosis of young patients with tongue carcinoma. Frontiers in oncology, 12:959749, 2022

15. Adachi M, Aoyama N, Kojima M, Sakamoto N, Miyazaki S, Taki T, Watanabe R, Matsuura K, Kotani D, Kojima T, Fujita T, Tabuchi K, Ishii G, Sakashita S. The area of residual tumor predicts esophageal squamous cell carcinoma prognosis following neoadjuvant chemotherapy. Journal of cancer research and clinical oncology, 2022

16. Nakazato A, Mochizuki M, Shibuya-Takahashi R, Fujimori H, Fujii K, Saijoh S, Morita S, Yamazaki T, Imai T, Sato I, Satoh K, Yamaguchi K, Sugamura K, Yasuda J, Matsuura K, Shojaku H, Asada Y, Tamai K. RELA is required for CD271 expression and stem-like characteristics in hypopharyngeal cancer. Scientific reports, 12:17751, 2022

17. Morishita Y, Takenouchi K, Sakashita S, Matsuura K, Hayashi R, Nakatsura T. Immunohistochemical Analysis of Common Cancer Antigens in Head and Neck Squamous Cell Carcinoma. Anticancer research, 42:5751-5761, 2022