Induction chemotherapy-based organ-preservation protocol improve the function preservation compared with immediate total laryngectomy for locally advanced hypopharyngeal cancer-Results of a matched-pair analysis

Cancer Med. 2023 Aug;12(16):17078-17086. doi: 10.1002/cam4.6354. Epub 2023 Jul 19.

Abstract

Background: We performed a paired analysis to compare the therapeutic effect between the induction chemotherapy-based organ-preservation approach and immediate total laryngectomy in hypopharyngeal squamous cell carcinoma patients requiring total laryngectomy.

Methods: 351 patients who were treated with organ-preservation approach were compared with 110 patients who were treated with total laryngectomy. The main measures and outcomes were progression-free survival (PFS), overall survival (OS), and larynx function preservation survival (LFPS).

Results: No statistical difference was observed for 3-, 5-, and 10-year PFS and OS in two groups. In the organ-preservation group, the 3-, 5-, and 10-year LFPS was 30.7%, 23.3%, and 16.6%, respectively. The LFPS of Stage III > Stage IV, N0 > N1 > N2 > N3, T2 > T3 > T4, CR > PR > SD > PD patients (all p values <0.05).

Conclusions: Survival outcomes did not significantly differ between the two groups. The organ-preservation approach allowed more than 70% of the survivors to retain their larynx function.

Keywords: chemotherapy; hypopharyngeal cancer; laryngectomy; organ preservation; surgery.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Head and Neck Neoplasms* / pathology
  • Humans
  • Hypopharyngeal Neoplasms* / drug therapy
  • Hypopharyngeal Neoplasms* / surgery
  • Induction Chemotherapy / methods
  • Laryngeal Neoplasms* / drug therapy
  • Laryngeal Neoplasms* / surgery
  • Laryngectomy / methods
  • Matched-Pair Analysis
  • Neoplasm Staging
  • Retrospective Studies