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.

BACKGROUND

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).

METHODS

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.

RESULTS

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.

CONCLUSIONS

Prior HNSCC is the dominant predictor of post-TOVS EFS, supporting risk-adapted surveillance.