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Annals of Surgical Oncology

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

Young Min Park MD, PhD, Ki Chang Keum MD, PhD, Hye Ryun Kim MD, PhD, Byoung Chul Cho MD, PhD, Da Hee Kim MD, Nam Hoon Cho MD, PhD, Se-Heon Kim MD, PhD
Head and Neck Oncology
Volume 25, Issue 4 / April , 2018

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.

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