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Background <p>Head and neck squamous cell carcinoma (HNSCC) have poor outcomes in advanced stages. Early detection and minimally invasive treatment are essential. Endoscopic laryngo-pharyngeal surgery (ELPS), guided by narrowband imaging, is widely used in Asia, but its prognostic value remains unclear.</p> Methods <p>We retrospectively analyzed 111 patients with superficial HNSCC who were treated with ELPS between 2014 and 2023. Patient background, treatment results, complications, and prognostic factors were assessed.</p> Results <p>The median observation period was 56&#xa0;months. En bloc resection was achieved in 96.4% of cases, and the 5-year overall survival (OS) was 91.6%. Tumor thickness &gt; 1000&#xa0;μm was associated with metastasis in univariate analysis, whereas multivariate analysis identified tumor size &gt; 20&#xa0;mm and lymphatic invasion as independent predictors. Patients with a body mass index &lt; 18.5 had poorer OS, primarily owing to comorbidities rather than HNSCC. Adverse events occurred in 26.1% of patients, most of which were transient laryngeal edema. One patient required a temporary tracheotomy, but no permanent tracheostomy was needed. ELPS was feasible and safe, even in patients with prior chemoradiotherapy (CRT), as no fatal complications were observed.</p> Conclusions <p>ELPS provides favorable mid- to long-term outcomes and can be safely applied to selected patients, including those with prior CRT. Tumor size and lymphatic invasion are key prognostic factors. These findings support ELPS as a minimally invasive, function-preserving treatment option for superficial HNSCC with careful patient selection.</p> Graphic Abstract <p></p>

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Clinical outcomes and prognostic significance of endoscopic laryngo-pharyngeal surgery for head and neck squamous cell carcinoma: a retrospective analysis of 111 cases

  • 期刊论文

  • 发表日期：

    2025年11月24日

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  • Sakiko Naito,
  • Hayato Yamaguchi,
  • Hiroki Sato,
  • Midori Mizumachi,
  • Tadashi Ichimiya,
  • Takahiro Muramatsu,
  • Yasuyuki Kagawa,
  • Takashi Morise,
  • Isaku Okamoto,
  • Masakatsu Fukuzawa,
  • Kiyoaki Tsukahara,
  • Toshitaka Nagao,
  • Takao Itoi

摘要

Background

Head and neck squamous cell carcinoma (HNSCC) have poor outcomes in advanced stages. Early detection and minimally invasive treatment are essential. Endoscopic laryngo-pharyngeal surgery (ELPS), guided by narrowband imaging, is widely used in Asia, but its prognostic value remains unclear.

Methods

We retrospectively analyzed 111 patients with superficial HNSCC who were treated with ELPS between 2014 and 2023. Patient background, treatment results, complications, and prognostic factors were assessed.

Results

The median observation period was 56 months. En bloc resection was achieved in 96.4% of cases, and the 5-year overall survival (OS) was 91.6%. Tumor thickness > 1000 μm was associated with metastasis in univariate analysis, whereas multivariate analysis identified tumor size > 20 mm and lymphatic invasion as independent predictors. Patients with a body mass index < 18.5 had poorer OS, primarily owing to comorbidities rather than HNSCC. Adverse events occurred in 26.1% of patients, most of which were transient laryngeal edema. One patient required a temporary tracheotomy, but no permanent tracheostomy was needed. ELPS was feasible and safe, even in patients with prior chemoradiotherapy (CRT), as no fatal complications were observed.

Conclusions

ELPS provides favorable mid- to long-term outcomes and can be safely applied to selected patients, including those with prior CRT. Tumor size and lymphatic invasion are key prognostic factors. These findings support ELPS as a minimally invasive, function-preserving treatment option for superficial HNSCC with careful patient selection.

Graphic Abstract