Adverse event risks and prognostic factors associated with endoscopic laryngopharyngeal surgery for superficial head and neck cancer after chemoradiotherapy
- 1Department of Gastroenterology and Hepatology, Tokyo Medical University, 6-7-1, Nishinjuku, Shinjuku-ku, Tokyo, 160-0023 Japan
- 2Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, 6-7-1, Nishinjuku, Shinjuku-ku, 160-0023 Tokyo, Japan
Abstract
Background: Endoscopic laryngopharyngeal surgery (ELPS) is an organ-preserving treatment for superficial head and neck squamous cell carcinoma (sHNSCC). While ELPS shows favorable outcomes in primary and metachronous lesions, its role as salvage treatment following chemoradiotherapy (CRT) remains unclear. We evaluated the clinical outcomes of salvage ELPS and factors associated with adverse events (AEs) and prognosis.
Methods: Among 136 patients undergoing ELPS between 2014 and 2024, we retrospectively analyzed 17 diagnosed with sHNSCC following CRT. Patients were categorized into salvage and metachronous groups, and clinical characteristics, treatment outcomes, AEs, and survival were compared.
Results: The en bloc resection rate was 100%. AEs occurred in 47.1% of patients and were more frequent in the salvage group than in the metachronous group (70.0% vs. 14.3%, p=0.024). Body mass index (BMI) <18.5 kg/m2 was significantly associated with AEs (p=0.043). 4-year overall survival (OS) did not differ significantly between groups (83.3% vs. 71.4%), while 12-month relapse-free survival tended to be lower in the salvage group (68.6% vs. 85.7%). BMI was also associated with OS: patients with BMI ≥18.5 kg/m2 had a 4-year OS of 81.8%, compared with 50% for patients with BMI <18.5 kg/m2 (p=0.036).
Conclusion: Salvage ELPS for sHNSCC was associated with a higher AE risk but showed long-term survival outcomes comparable to metachronous ELPS. Nutritional status, particularly low BMI, is a key determinant of safety and prognosis. These findings support the feasibility of ELPS as an organ-preserving strategy and emphasize the importance of careful patient selection and nutritional assessment in salvage settings.
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BibTeX
@article{naito2026adverse,
title = {{Adverse event risks and prognostic factors associated with endoscopic laryngopharyngeal surgery for superficial head and neck cancer after chemoradiotherapy}},
author = {Sakiko Naito and Hayato Yamaguchi and Masakatsu Fukuzawa and Isaku Okamoto and Kiyoaki Tsukahara and Takao Itoi},
journal = {International Journal of Clinical Oncology},
year = {2026},
month = sep,
doi = {10.1007/s10147-026-03186-w},
url = {https://doi.org/10.1007/s10147-026-03186-w},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Adverse event risks and prognostic factors associated with endoscopic laryngopharyngeal surgery for superficial head and neck cancer after chemoradiotherapy
AU - Sakiko Naito
AU - Hayato Yamaguchi
AU - Masakatsu Fukuzawa
AU - Isaku Okamoto
AU - Kiyoaki Tsukahara
AU - Takao Itoi
PY - 2026
DA - 2026/09/19
JO - International Journal of Clinical Oncology
DO - 10.1007/s10147-026-03186-w
UR - https://doi.org/10.1007/s10147-026-03186-w
AB - Background: Endoscopic laryngopharyngeal surgery (ELPS) is an organ-preserving treatment for superficial head and neck squamous cell carcinoma (sHNSCC). While ELPS shows favorable outcomes in primary and metachronous lesions, its role as salvage treatment following chemoradiotherapy (CRT) remains unclear. We evaluated the clinical outcomes of salvage ELPS and factors associated with adverse events (AEs) and prognosis. Methods: Among 136 patients undergoing ELPS between 2014 and 2024, we retrospectively analyzed 17 diagnosed with sHNSCC following CRT. Patients were categorized into salvage and metachronous groups, and clinical characteristics, treatment outcomes, AEs, and survival were compared. Results: The en bloc resection rate was 100%. AEs occurred in 47.1% of patients and were more frequent in the salvage group than in the metachronous group (70.0% vs. 14.3%, p=0.024). Body mass index (BMI) <18.5 kg/m2 was significantly associated with AEs (p=0.043). 4-year overall survival (OS) did not differ significantly between groups (83.3% vs. 71.4%), while 12-month relapse-free survival tended to be lower in the salvage group (68.6% vs. 85.7%). BMI was also associated with OS: patients with BMI ≥18.5 kg/m2 had a 4-year OS of 81.8%, compared with 50% for patients with BMI <18.5 kg/m2 (p=0.036). Conclusion: Salvage ELPS for sHNSCC was associated with a higher AE risk but showed long-term survival outcomes comparable to metachronous ELPS. Nutritional status, particularly low BMI, is a key determinant of safety and prognosis. These findings support the feasibility of ELPS as an organ-preserving strategy and emphasize the importance of careful patient selection and nutritional assessment in salvage settings.
SN - 1341-9625
SN - 1437-7772
ER -