International consensus on laryngeal preservation strategies in laryngeal and hypopharyngeal cancer

Lancet Oncol. 2025 May;26(5):e264-e281. doi: 10.1016/S1470-2045(25)00020-8.

Abstract

This Policy Review summarises an expert Delphi consensus process on larynx-preservation treatments in patients affected by intermediate-to-advanced laryngeal or hypopharyngeal squamous cell carcinoma. The experts, who represented all perspectives involved in multidisciplinary management of these patients and included patient representatives, approved 137 consensus statements that cover several relevant areas in the field of larynx-preserving treatments. Statements are grouped in the following topics: granular indications for T2-T3 cancer, indications for T4a cancer, indications for salvage organ-preservation surgery after chemoradiation failure, laryngeal function at baseline, which comorbidities are contraindications and to what extent, organ preservation in older patients: selection criteria, post-treatment surveillance, prognostic and predictive factors, listening to the patient's preferences: tools and implementation, prehabilitation and rehabilitation protocols, and cost-effectiveness of different laryngeal preservation approaches. We present a high-level summary of the results of the consensus process, with detailed reference to the full list of statements and supporting literature.

Publication types

  • Review

MeSH terms

  • Consensus
  • Delphi Technique
  • Humans
  • Hypopharyngeal Neoplasms* / pathology
  • Hypopharyngeal Neoplasms* / surgery
  • Hypopharyngeal Neoplasms* / therapy
  • Laryngeal Neoplasms* / pathology
  • Laryngeal Neoplasms* / surgery
  • Laryngeal Neoplasms* / therapy
  • Larynx* / pathology
  • Larynx* / surgery
  • Organ Sparing Treatments* / adverse effects
  • Organ Sparing Treatments* / methods
  • Salvage Therapy
  • Squamous Cell Carcinoma of Head and Neck / pathology