A Clinical Trial of Combination Neoadjuvant Chemotherapy and Transoral Robotic Surgery in Patients with T3 and T4 Laryngo-Hypopharyngeal Cancer

Ann Surg Oncol. 2018 Apr;25(4):864-871. doi: 10.1245/s10434-017-6208-5. Epub 2017 Oct 30.

Abstract

Background: We conducted a prospective clinical trial of combination neoadjuvant chemotherapy, transoral robotic surgery (TORS), and customized adjuvant therapy in patients with locally advanced laryngo-hypopharyngeal cancer.

Methods: Between September 2008 and August 2016, 35 patients were enrolled in this clinical trial.

Results: Twenty patients had hypopharyngeal cancer and 15 had laryngeal cancer. Twenty-nine patients (82.9%) had T3 disease and six patients (17.1%) had T4 disease, while 12 patients (34.3%) had stage III disease and 23 patients (65.7%) had stage IV disease. The 3-year disease-specific survival rate was 82.4% and the 3-year disease-free survival rate was 69.48%. Decannulation was successful in 31 of 34 patients at an average of 18 days postoperatively. Among all patients, 83% exhibited a favorable subjective swallowing status, while five patients (14.4%) became dependent on feeding tubes.

Conclusions: Neoadjuvant chemotherapy combined with TORS and customized adjuvant therapy, based on detailed pathological information, afforded favorable oncological outcomes and preserved organ functionalities in T3-T4 laryngo-hypopharyngeal cancer.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / therapy*
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Hypopharyngeal Neoplasms / pathology
  • Hypopharyngeal Neoplasms / therapy*
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / therapy*
  • Male
  • Middle Aged
  • Mouth
  • Neoadjuvant Therapy / mortality*
  • Neoplasm Staging
  • Prospective Studies
  • Robotic Surgical Procedures / mortality*
  • Survival Rate