Innovative Treatment Modalities for Laryngeal and Hypopharyngeal Cancers

PROGRAM DESCRIPTION: The larynx and hypopharynx play crucial roles in phonation, swallowing, and respiration. Beyond radiotherapy with or without chemotherapy, recent advancements focus on less-invasive, organ-preserving surgical approaches, including transoral robotic surgery (TORS) using the da Vinci system. This symposium will highlight innovative TORS techniques for glottic cancer involving the anterior commissure (a form of supracricoid laryngectomy preserving the thyroid cartilage) and pyriform sinus cancer resection without temporary tracheostomy. Neoadjuvant chemotherapy (NACT) has gained attention for facilitating organ-preserving surgery, but the standard TPF regimen (docetaxel, cisplatin, 5-FU) is highly toxic and may delay surgery. We will present a modified NACT protocol using split-dose docetaxel and cisplatin with oral tegafur/uracil (DCU), which effectively downstages advanced tumors and supports organ preservation. For advanced T3/T4 hypopharyngeal cancers unsuitable for transoral surgery, partial laryngopharyngectomy with flap reconstruction—such as submental, supraclavicular artery island, or pectoralis major myocutaneous flaps—offers an alternative to preserve function. If organ preservation is not feasible, transoral robotic total laryngectomy minimizes surgical trauma. For total laryngopharyngectomy cases, flaps like ileocolic, radial forearm, or anterolateral thigh (ALT) can restore swallowing function. This symposium aims to showcase innovative treatments for laryngeal and hypopharyngeal cancers beyond chemoradiation, advancing both organ preservation and functional outcomes. The program also includes surgical video presentations, offering detailed insights into innovative techniques.

OUTCOME OBJECTIVE 1: Discover the regimen and preliminary outcomes of a less toxic modified NACT protocol combining split-dose docetaxel and cisplatin with oral tegafur/uracil (DCU), which effectively downstages advanced tumors and facilitates organ-preserving surgery.

OUTCOME OBJECTIVE 2: Understand the strategy and principles of utilizing TORS to de-escalate radiotherapy. Explore the techniques and outcomes of TORS in the treatment of hypopharyngeal and laryngeal cancers. Includes surgical video presentations, offering detailed insights into innovative techniques.

OUTCOME OBJECTIVE 3: Learn about flap reconstruction techniques and outcomes in open partial laryngopharyngectomy for organ preservation. Explore flap options for total laryngopharyngectomy and their treatment results. Includes surgical video presentations for surgical techniques.

BACKGROUND STATEMENT: Patients with laryngeal and hypopharyngeal cancers require more treatment options that prioritize organ and function preservation while minimizing complications. This topic aims to inform the audience about various treatment strategies that can enhance their patients' quality of life.

Comprehensive Otolaryngology Track Statement :