Laryngeal and Hypopharyngeal Malignancies: Where Do We Stand? A Retrospective Single-center Study

Squamous cell carcinoma (SCC) of the larynx and hypopharynx shows subsite-specific patterns, with supraglottic tumors closely resembling hypopharyngeal SCC. This study aimed to analyze 10-year epidemiologic trends, management, and outcomes in a tertiary hospital, with emphasis on prognostic similarities between supraglottic and hypopharyngeal tumors.

A retrospective cohort of 454 patients with laryngeal or hypopharyngeal SCC (2012-2022) was evaluated. Demographic characteristics, TNM stage, treatment modality, and 5-year disease-specific survival (DSS) were analyzed.

Hypopharyngeal SCC cases were predominantly advanced (T3-T4: 66.4%; N2-N3: 82.7%) and more often metastatic (29.8%), compared with laryngeal SCC (40.6%, 21.1%, and 5.4%, respectively; p<0.0001). Within laryngeal subsites, supraglottic tumors closely resembled hypopharyngeal SCC in stage distribution, nodal burden, metastasis rate (10.3%), and the 5-year DSS (50.0%). Glottic tumors achieved favorable outcomes (5-year DSS 87.3%). Overall, DSS was 73.3% for laryngeal vs. 49.4% for hypopharyngeal SCC (p<0.0001). Treatment trends showed a shift toward organ-preserving strategies in laryngeal SCC, while hypopharyngeal SCC consistently relied on non-surgical therapy.

Over the past decade, the incidence, demographics, and stage distribution of laryngeal and hypopharyngeal SCC remained stable. Although laryngeal SCC management increasingly favored organ preservation, hypopharyngeal SCC persisted as an advanced-stage disease primarily treated with non-surgical approaches. Five-year DSS remained substantially poorer for hypopharyngeal SCC. Supraglottic laryngeal tumors shared clinical and prognostic characteristics with hypopharyngeal SCC, including advanced stage, high metastatic rate, and inferior survival. The notable prevalence of distant metastases-nearly 30% in hypopharyngeal and 10% in supraglottic SCC-underscores the importance of incorporating PET/CT or PET/MR into baseline staging and highlights the need for multicenter studies to optimize management of these high-risk subgroups.