title: Conservation surgery for hypopharyngeal cancer: changing paradigm from open to endoscopic.
abstract: CONCLUSIONS
  Endoscopic laser microsurgery (ELM) provides comparable oncological outcomes, and improved functional recovery and laryngeal preservation compared with open partial laryngopharyngectomy (OPLP) in patients with early squamous cell carcinoma of the hypopharynx (HPSCC). The use of open surgery is declining. The outcome of the study provides evidence-based recommendations for surgical choices in HPSCC treatment. However, it is not conclusive without a larger prospective study.
  
  
  OBJECTIVE
  To compare the functional and oncological results of ELM and OPLP in HPSCC and examine surgical trends.
  
  
  METHODS
  From 1990 to 2008, 53 HPSCC patients undergoing ELM (n = 25) and OPLP (n = 28) were included. Functional recovery, oncological results, and laryngeal preservation rate were analyzed.
  
  
  RESULTS
  Patients who underwent ELM demonstrated a shorter decannulation period (7 vs 11 days, p = 0.010), time using a nasogastric tube (7 vs 16 days, p = 0.043), and hospitalization stay (12 vs 22 days, p = 0.0061) than those who underwent OPLP. The 3-year overall and disease-specific survival rates were comparable between ELM and OPLP (79% vs 64%, p = 0.151, and 83% vs 71%, p = 0.320, respectively). The ELM patients had better laryngeal preservation (92% vs 71%, p = 0.048). The number of OPLPs performed has decreased since 2000 (68% before vs 32% after, p < 0.0001).
authors.affiliation: Department of Otorhinolaryngology, Taoyuan Armed Forces General Hospital, Taoyuan , Taiwan, R.O.C.
authors.forename: Chin-Lung
authors.initials: CL
authors.lastname: Kuo
authors.forename: Tsung-Lun
authors.initials: TL
authors.lastname: Lee
authors.forename: Pen-Yuan
authors.initials: PY
authors.lastname: Chu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D010611:Pharyngectomy / Q000379:methods*; D011446:Prospective Studies; D015996:Survival Rate / Q000639:trends; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome