Developments in diagnosis and treatment of early hypopharyngeal carcinoma and precancerous lesions: A review

早期下咽癌及癌前病变诊断和治疗进展:综述

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Abstract

Hypopharyngeal carcinoma (HC) is one of the rarest and worst head and neck cancers (HNC) with insidious location, atypical early symptoms, and frequently diagnosed in advanced stages. The risk factors of HC mainly include smoking and drinking. Preventive interventions directed towards environmental risk factors are highly likely to yield far-reaching beneficial effects in reducing the incidence of this disease. The majority of advanced HC patients undergo multimodal treatments that encompass radiotherapy, chemotherapy and surgery, with poor oncological and functional outcomes. The early diagnosis and management of HC are vital for improving the prognosis of patients. Currently, there are few reviews specifically focusing on early HC, thus this review aims to summarize the current advancements in the diagnosis and management of early HC. Magnifying endoscopy with narrow-band imaging (ME-NBI) can improve the detection rate of early lesions and assess the invasion depth by enhancing the visualization of microvascular patterns. In recent years, artificial intelligence (AI) presents a promising prospect in the detection of early HC through deep learning algorithms. Larynx-preserving surgery or radiotherapy alone is predominantly recommended for individuals diagnosed at an early stage, aiming to achieve optimal oncological control while preserving crucial functions. With the increasing detection rates of early HC and the development of surgical equipment, transoral minimally invasive surgery is becoming more widely applied in HC. Its minimally invasive nature offers reduced morbidity and faster recovery, making it an attractive option for eligible patients with early HC.

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