title: Transoral laser microsurgery as standard approach to hypopharyngeal cancer. Survival analysis in a hospital based population.
abstract: OBJECTIVE
  Cancer of the hypopharynx remains one of the most challenging chapters in head and neck oncology. The objective of this study is to ascertain the relevance of a transoral laser approach as a valid functional option for treatment of cancer of the hypopharynx in Portugal, and additionally, to confirm the reproducibility of survival and functional outcomes described in other reference centers.
  
  
  METHODS
  The outcomes of 37 out of 60 patients presenting hypopharyngeal carcinoma primarily treated by TLM (transoral laser microsurgery) and neck dissection and or adjuvant treatment when needed, with curative intention in tertiary referral center, were retrospectively evaluated and compared with published results.
  
  
  RESULTS
  There were no patients in stage I. Three-year and five-year overall survival (Kaplan-Meier) were 83.5% and 63.5% for stage II (n=12), 57.1% (only 3-year overall survival evaluable for this stage) for stage III (n=7), and 53.1% and 39.8% for stage IVa (n=18), respectively. Five-year local control rates were 90% for stage II and 87.5% for stage IVa, respectively; only three-year local control rates were possible to evaluate for stage III, with a 100% control rate. Five-year total larynx preservation rate was 97.3%.
  
  
  CONCLUSIONS
  TLM, alone or with neck dissection and adjuvant therapy, is a valid procedure for treatment of hypopharyngeal cancer in different stages. Furthermore, this kind of approach can be replicated in different oncologic centers with similar oncologic and functional results.
authors.affiliation: Department of Otolaryngology, Portuguese Institute of Oncology Dr Francisco Gentil, Porto, Portugal. Electronic address: erbreda@gmail.com.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Breda
authors.affiliation: Molecular Oncology GRP CI, Portuguese Institute of Oncology Dr Francisco Gentil, Porto, Portugal.
authors.forename: Raquel
authors.initials: R
authors.lastname: Catarino
authors.affiliation: Department of Otolaryngology, Portuguese Institute of Oncology Dr Francisco Gentil, Porto, Portugal.
authors.forename: Eurico
authors.initials: E
authors.lastname: Monteiro
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006761:Hospitals; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality* / Q000601:surgery*; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D009055:Mouth; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Cancer; Carcinoma; Cirugía; Control local; Cáncer; Escamoso; Hipofaringe; Hypopharynx; Laser; Local control; Láser; Microcirugía láser transoral; Organ preservation; Piriform; Piriforme; Preservación de órgano; Squamous; Supervivencia; Surgery; Survival; Transoral laser microsurgery