History of Head and Neck Cancer as a Predictor of Recurrence and Second Primary Tumors After Transoral Videolaryngoscopic Surgery in Patients With Hypopharyngeal Squamous Cell Carcinoma.

Abstract

Surveillance after transoral videolaryngoscopic surgery (TOVS) for early-stage hypopharyngeal squamous cell carcinoma (HPSCC) remains unvalidated, particularly regarding posttreatment local recurrence and second primary head and neck squamous cell carcinoma (HNSCC). We retrospectively reviewed 84 patients with early-stage HPSCC treated with TOVS at a single high-volume center. Post-TOVS "HNSCC events" were defined as local recurrence or second primary HNSCC diagnosed after TOVS. Event-free survival (EFS) was defined as time to first post-TOVS HNSCC event or death. Median follow-up was 49.3 months. Two-year EFS and overall survival (OS) were 49.0% and 93.8%, and 2-year cause-specific survival was 100%. Prior HNSCC before the index HPSCC independently predicted worse EFS (HR 4.3, 95% CI 2.3-8.0; p < 0.0001): 2-year EFS was 73.8% without versus 23.0% with prior HNSCC, while OS and cause-specific survival were comparable. Prior HNSCC is the dominant predictor of post-TOVS EFS, supporting risk-adapted surveillance.