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

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

Author information

1
Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea.
2
Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea.
3
Department of Medical Oncology, Yonsei University College of Medicine, Seoul, Korea.
4
Department of Otorhinolaryngology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Korea.
5
Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.
6
Department of Otorhinolaryngology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Korea. shkimmd@yuhs.ac.

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.

PMID:
29086129
DOI:
10.1245/s10434-017-6208-5
[Indexed for MEDLINE]

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