09-12, 17:00–18:00 (Europe/Istanbul), Head & Neck Surgery 3
Description: This proposal is focused on discussing the surgical feasibility of laryngeal preservation in advanced T3/T4 head and neck cancer, using the cricoarytenoid joint status as the primary assessment criterion. It is based on a a prospective, monocentric study conducted from 2020 to 2023, involving 162 patients with advanced T3/T4 squamous cell carcinoma of the head and neck. The study also assessed survival and dysphagia outcomes. Laryngeal preservation was feasible in 88% of cases when the cricoarytenoid joint was not invaded. No significant difference in recurrence-free survival was found between the laryngectomy and larynx preservation groups (78.9% vs. 85.1% recurrence-free rates). Transoral surgery resulted in faster recovery than open surgery (p = 0.001) and better overall survival (92.6% vs. 70.0%, p = 0.38). Long-term dysphagia levels and recurrence-free survival rates were similar between different surgical approaches.
Outcome Objectives: Define the theoretically possible limits for surgical preservation of the larynx and explore the possibilities of preservation surgery in advanced head and neck carcinoma beyond the theoretical red line of cricoarytenoid invasion in all directions.
Popov et al. Large monocentric prospective study on feasibility of functional preservation surgery of T3/T4 head and neck cancer - a pirouette around the cricoarytenoid joint. (under review)
Popov et al. Oncological outcomes of primary laryngectomy in T4 laryngopharyngeal cancer – study of 76 cases. Laryngorhinootologie 2019; 98(S 02): S80DOI: 10.1055/s-0039-1686049
Popov, T.M., Stancheva, G., Kyurkchiyan, S.G. et al. Global microRNA expression profile in laryngeal carcinoma unveils new prognostic biomarkers and novel insights into field cancerization. Sci Rep 12, 17051 (2022). https://www.nature.com/articles/s41598-022-20338-w
After the advent of non-surgical laryngeal preservation protocols in locally advanced cancer, the treatment paradigm gradually shifted away from the definitive curative surgical strategies towards functional sustainability and quality of life conservation – characteristics that chemoradiotherapy claimed superiority. This swing of the pendulum is still debatable since global retrospective big data analysis show discrepancies between real world results and the high-end clinical trials published in the literature. In the light of this perspective, we should reevaluate and even reinvent the existing value of surgery in modern treatment concepts by reaching its maximum in terms of upper airway function preservation.
Dr. Todor Popov is current Head of Department of ENT at the Medical University - Sofia, Bulgaria, a position he has held since May 2023. His surgical expertise encompasses a wide range of areas including head and neck surgery, microsurgical free flap reconstruction, transoral laser surgery, endoscopic sinus and skull base surgery, treatment of laryngeal stenosis, and various ear surgeries including cochlear implants. Dr. Popov's research focuses on genetics and epigenetics of head and neck carcinoma, neoangiogenesis, microRNAs, cancer field theory, and biomarkers. He has led several research projects and published numerous papers in reputable journals, demonstrating his significant contributions to the field. Fluent in English and German. Dr. Popov has participated in numerous fellowships and courses across Europe, continuously enhancing his skills in various aspects of ENT surgery. He has also been involved in multiple research projects, with a particular focus on microRNA expression in laryngeal carcinoma and its implications for prognosis and treatment. His work has been presented at major international congresses, including the European ORL-HNS Congress and the European Rhinologic Society Congress.
Jerome R. Lechien is head and professor of general surgery at the University of Mons. He is otolaryngologist with fellowship in laryngology and robotic head and neck surgery.
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Giovanni Succo, MD
Otorhinolaryngologist and Surgical Oncologist
Full Professor Otolaryngology/Head and Neck Surgery – Dept. Oncology – University of Turin
Chair Otolaryngology/Head and Neck Unit - San Giovanni Bosco Hospital – Turin
President of European Head and Neck Society
President of Italian University Society of Otolaryngology
Past President of Italian Head and Neck Society
Author of 147 peer reviewed papers and many book chapters mainly focused on laryngeal oncology, partial laryngectomies and, the last ones, on mini-invasive 3D exoscopic surgery.
Otorhinolaryngologist and Surgical Oncologist
Full Professor Otolaryngology/Head and Neck Surgery – Dept. Oncology – University of Turin
Chair Otolaryngology/Head and Neck Unit - San Giovanni Bosco Hospital – Turin
President of European Head and Neck Society
President of Italian University Society of Otolaryngology
Past President of Italian Head and Neck Society
Author of 147 peer reviewed papers and many book chapters mainly focused on laryngeal oncology, partial laryngectomies and, the last ones, on mini-invasive 3D exoscopic surgery.