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Historically, PLE was associated with high morbidity and mortality. However, advances in surgical techniques, reconstructive methods, and perioperative care have significantly improved its safety and functional outcomes. Minimally invasive and hybrid PLE approaches reduce pulmonary complications and speed recovery without compromising oncologic outcomes. Chemoradiation has become the first-line treatment for many advanced cases, with PLE now reserved for selected cervical esophageal tumors or persistent disease after radiation. Neoadjuvant chemotherapy or chemoradiation can shrink tumors, improve operability, and sometimes allow organ preservation. Immunotherapy before surgery improves pathological response rates and disease-free survival. Recent series report 5-year survival of 20\u201340% after PLE, and most patients regain swallowing and voice function with rehabilitation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In the organ-preservation era, PLE remains important for certain advanced or treatment-resistant cases. Its role is defined by a multidisciplinary, personalized approach and limited to cases where surgery is essential, often combined with systemic therapy. Ongoing advances in patient selection, minimally invasive techniques, and immunotherapy are expected to further refine PLE\u2019s role and improve outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12957-026-04519-9","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T14:04:27Z","timestamp":1785506667000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bridging the gap: modern pharyngolaryngoesophagectomy techniques and the rise of neoadjuvant\/immunotherapy approaches"],"prefix":"10.1186","volume":"24","author":[{"given":"Freideriki","family":"Nteka","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania","family":"Triantafyllou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0774-1904","authenticated-orcid":false,"given":"Ioannis","family":"Rouvelas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Gkoutziotis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiotis","family":"Sakarellos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Tolia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Karavokyros","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Mpallas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Schizas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"4519_CR1","doi-asserted-by":"publisher","first-page":"1031","DOI":"10.3904\/kjim.2020.078","volume":"35","author":"K Jung","year":"2020","unstructured":"Jung K, Narwal M, Min SY, Keam B, Kang H. 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