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Updated: Jul 11, 2026
Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy
Published on: October 24, 2025
Preoperative concurrent chemoradiotherapy versus pre- and postoperative radiotherapy for advanced hypopharyngeal
Hiroshi Iwai1, Hisaya Yukawa, Motoki Nagata
1Department of Otolaryngology, Kansai Medical University, Osaka 570-8507, Japan. iwai@takii.kmu.ac.jp
Objective:
The purpose of this study was to improve the survival and phonatory rates in patients with advanced hypopharyngeal carcinoma.
Methods:
Seventy-two consecutive patients with advanced hypopharyngeal carcinoma were treated with pre- and postoperative radiotherapy (RTS), or preoperative concomitant chemoradiotherapy (CCRTS). Surgical procedures, including total laryngectomy plus partial pharyngectomy (TLPP) to preserve the posterior pharyngeal wall offering a functional neoglottis for esophageal or tracheoesophageal shunt phonation postoperatively, were conducted for patients who did not achieve CR.
Results:
A significantly higher survival rate at 5 years (93.3%) was observed for N0-2b stage patients in the CCRTS group (n=16) than the RTS group (n=34; 41.5%) (p<.005). The distant metastasis-free rate was 92.9% (CCRTS group) versus 55.4% (RTS group) (p<.05) in these patients. In the CCRTS group, the 5-year survival rate with laryngeal or esophageal and/or tracheoesophageal shunt phonation was 22.2%.
Conclusion:
It is suggested that the CCRTS protocol and TLPP procedure may improve the survival rates without deterioration of phonatory rates in patients with N0-2b advanced hypopharyngeal carcinoma.