Clinical Outcomes of Endoscopic Submucosal Dissection and Transoral Videolaryngoscopic Surgery for Superficial Hypopharyngeal Cancers

BACKGROUND: Minimally invasive treatments for superficial pharyngeal cancer including transoral videolaryngoscopic surgery (TOVS) and endoscopic submucosal dissection (ESD) have become more widespread as minimally invasive treatments; however, no reports have compared these treatment methods. METHODS: We retrospectively investigated consecutive patients with superficial hypopharyngeal squamous cell carcinoma who underwent ESD or TOVS between January 2013 and December 2024. RESULTS: A total of 60 lesions in 55 patients were included in the ESD and TOVS groups. The en bloc resection rate was 100% in both groups. The R0 resection rate in the ESD group showed a nonsignificant trend toward being higher than that in the TOVS group (58.1% vs. 34.5%; p = 0.077). No significant differences were observed in the 3-year overall survival (OS) rates between the TOVS and ESD groups (93.8% vs. 81.3%; p = 0.330). The 3-year cumulative incidence of local recurrence was 13.6% in the TOVS group and 5.9% in the ESD group (p = 0.241). In an exploratory univariate analysis, tumor thickness ≥ 1000 μm was significantly associated with lymph node metastasis (p = 0.017). CONCLUSIONS: Clinical outcomes in patients with superficial hypopharyngeal cancer were not significantly different between ESD and TOVS. Although the cumulative incidence of local recurrence was numerically lower after ESD than after TOVS, the difference was not statistically significant. Both procedures may represent feasible minimally invasive treatment options for selected patients.