Oncologic Outcomes and Treatment Feasibility of Transoral Carbon Dioxide Laser Microsurgery for Hypopharyngeal Tumors in Older Patients: A Retrospective Cohort Study

Background We evaluated outcomes and complications of transoral CO 2 laser microsurgery (TLM) for hypopharyngeal tumors and its feasibility in ≥ 75‐year‐old patients. Methods We retrospectively reviewed 116 patients (without metastases) treated from February 2012 to October 2024 at our hospital. Oncologic outcomes were analyzed using Kaplan–Meier curves (110 patients; median follow‐up: 5.3 years). Results Five‐year local control, disease‐specific survival, and overall survival rates were 87.8%, 94.6%, and 85.6%, respectively. Postoperative dysphagia, aspiration pneumonia, pharyngolaryngeal edema, and vocal fold paralysis occurred in 9%, 4%, 3%, and 3% of patients, respectively; none required tracheostomy or surgical hemostasis under general anesthesia. The group with a history of head and neck irradiation had higher rates of dysphagia ( p = 0.010) and aspiration pneumonia ( p = 0.031) than those without. Differences between age groups were nonsignificant. Conclusions TLM appears safe and effective for older patients with appropriately selected hypopharyngeal tumors.