Analysis of clinical efficacy and quality of life in hypopharyngeal cancer patients undergoing laryngeal-preserving surgery.

OBJECTIVE: This study analyzes the therapeutic efficacy of hypopharyngeal cancer following laryngeal function-preserving surgery, assesses the recovery of swallowing and vocal functions, provides a reference for the selection of surgical approaches and the implementation of postoperative rehabilitation training for swallowing and vocal functions, and thereby improves the therapeutic outcomes and quality of life of patients. METHODS: Date from 23 patients with hypopharyngeal carcinoma who underwent laryngeal function-preserving surgery at the Department of Otorhinolaryngology Head and Neck Surgery between January 2017 and January 2024 were retrospectively analyzed in February 2025. The Kaplan-Meier method was employed to calculate the 1-, 3-, and 5-year disease-free survival (DFS) and overall survival (OS) rates. Intergroup differences were compared using the log-rank test, and the COX proportional hazards regression model was applied to identify key prognostic risk factors. Swallowing function and swallowing-related quality of life were assessed via a combination of flexible endoscopic evaluation of swallowing (FEES) and the M.D. Anderson Dysphagia Inventory (MDADI) scale. Voice function and voice-related quality of life were comprehensively evaluated using acoustic parameters (shimmer, jitter, fundamental frequency [F0]), maximum phonation time (MPT) measurements, and the 10-Item Voice Handicap Index (VHI-10). Spearman's rank correlation analysis was used to explore the factors influencing postoperative swallowing and voice rehabilitation. RESULTS: The 1-, 3-, and 5-year OS rates were 87.51%, 53.33%, and 42.86%, respectively, while the corresponding 1-, 3-, and 5-year DFS rates were 71.93%, 46.72%, and 42.86%. Lymph node metastasis reduced OS (P < 0.05). FEES showed texture-dependent pharyngeal residue, rare solid-food aspiration but frequent laryngeal penetration for semi-liquids and liquids. Vocal acoustic/aerodynamic parameters and favorable MDADI (84.17 ± 12.18) and VHI-10 (10.17 ± 8.18) scores were recorded in 23 functional-assessed patients. CONCLUSION: Laryngeal function-preserving surgery yields satisfactory oncological outcomes for hypopharyngeal carcinoma patients, Most patients achieved acceptable swallowing and voice function with good quality of life. This surgical approach effectively balances oncological efficacy and preserves organ function.