{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T17:16:17Z","timestamp":1772990177203,"version":"3.50.1"},"reference-count":14,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T00:00:00Z","timestamp":1761264000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T00:00:00Z","timestamp":1761264000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2026,3]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n Organ preservation strategies are increasingly adopted for hypopharyngeal carcinoma, but functional outcomes may be suboptimal. Posttreatment tracheostomy dependence significantly increases morbidity and reduces quality of life. This study evaluated airway outcomes and oncologic results in patients treated with primary chemoradiotherapy (CRT) or upfront surgery.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective study included 165 patients, with data collected on demographics, treatment type, tracheostomy status, and oncologic outcomes. The primary endpoint was long\u2010term tracheostomy dependence. Oncologic outcomes, including local control, disease\u2010free survival (DFS), and overall survival (OS), were analyzed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among the 165 patients included, 139 had advanced\u2010stage disease; 54 received CRT and 85 underwent upfront surgery. The 5\u2010year OS rate was significantly higher with surgery (40.0%) than CRT (18.4%). Patients who underwent total laryngectomy (TL) had higher 5\u2010year OS (35.5% vs. 28.6%) and 3\u2010year DFS (41.9% vs. 27.3%) compared to those managed with organ preservation. When stratified by airway status, 5\u2010year OS was 58.8% in patients with preserved airways, 29.3% after TL, and 6.7% in those with long\u2010term tracheostomy dependence. Notably, emergency tracheostomy (\n n<\/jats:italic>\n \u2009=\u200941) was associated with significantly poorer OS (12.2%), and none of these patients retained their native airway. Overall, 75.54% (105\/139) of advanced\u2010stage patients ultimately lost their native airway, including 55.84% (43\/77) of those who initially pursued an organ preservation strategy.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Patients with long\u2010term tracheostomy dependence exhibited the poorest prognosis and highest recurrence rates. Emergency tracheostomy was a strong predictor of long\u2010term dependence. Upfront surgery may be more appropriate for patients with impaired baseline laryngeal function.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence<\/jats:title>\n 3.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/lary.70215","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T12:06:51Z","timestamp":1761307611000},"page":"1416-1424","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Tracheostomy Dependence in Hypopharyngeal Cancer: Comparative Prognostic Impact of\n CRT<\/scp>\n Versus Surgery"],"prefix":"10.1002","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9109-1223","authenticated-orcid":false,"given":"Chien\u2010Yi","family":"Yang","sequence":"first","affiliation":[{"name":"Division of General Surgery, Department of Surgery, Tri\u2010Service General Hospital Songshan Branch National Defense Medical University Taipei Taiwan (ROC)"},{"name":"Department of Health Promotion and Health Education National Taiwan Normal University Taipei Taiwan (ROC)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun\u2010Shu","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Tri\u2010Service General Hospital National Defense Medical University Taipei Taiwan (ROC)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chieh Hsing","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Health Promotion and Health Education National Taiwan Normal University Taipei Taiwan (ROC)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9730-1798","authenticated-orcid":false,"given":"Shao\u2010Cheng","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Tri\u2010Service General Hospital National Defense Medical University Taipei Taiwan (ROC)"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,24]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199106133242402"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.75.7385"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.30844"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.27935"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anorl.2014.01.006"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2009.01.058"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(25)00020-8"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.1811"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.130.7.875"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23508"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2016.10.001"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-018-5241-8"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.27195"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25585"}],"container-title":["The 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