2023 Volume 116 Issue 5 Pages 441-447
Endoscopic laryngopharyngeal surgery (ELPS) is a minimally invasive therapy, in which superficial lesions are resected directly with the assistance of a laryngoscope.
On the other hand, ELPS is difficult to perform in several cases of hypopharyngeal cancer because of previous therapies, including radiotherapy and/or chemotherapy. Unfortunately, such cases require total laryngopharyngectomy with cervical esophagectomy for radical cure.
Herein, we report two cases of cancer of the hypopharynx in whom we performed ELPS after chemotherapy. The first patient had received chemotherapy (taxotere, cisplatin,5-fluorouracil) for co-existing esophageal cancer. After 2 cycles of this chemotherapy, the hypopharyngeal tumor almost disappeared endoscopically and was resected by ELPS. The other patient had previously received radiation therapy for malignant lymphoma (mantle irradiation) and developed hypopharyngeal carcinoma involving the cervical esophagus. Because the patient did not wish to have a major operation, we selected chemotherapy (cisplatin,5-fluorouracil, cetuximab). After 4-cycles of this chemotherapy, the tumor decreased in size, and we performed ELPS. The laryngeal function is well-preserved in both cases, and neither case has shown recurrence.
It appears that the combination of induction chemotherapy and ELPS is useful for the treatment of hypopharyngeal cancer with preservation of the laryngeal function.
