Ten-year outcome of curative "exclusive" chemotherapy in N0M0 squamous cell carcinoma of the larynx and pharynx with complete clinical response.

BACKGROUND: The aim of our study was to document 10-year outcome after curative "exclusive" chemotherapy in N0M0 squamous cell carcinoma of the larynx and pharynx.

METHODS: Retrospective nonrandomized analysis of an inception cohort of 191 patients. Platinum salt and 5-fluorouracil were used in all patients.

RESULTS: The 3-, 5-, 10-year overall actuarial survival and local control estimates were 83.3%, 74.4%, and 55.4% and 62.1%, 62.1%, and 55.3%, respectively. Main causes of death were metachronous second primary cancer (n = 39) and intercurrent disease (n = 28). No clinical variables were associated with increased risk of local recurrence. Salvage treatment resulted in 94.7% ultimate local control and 88.4% organ preservation. "Exclusive" chemotherapy was considered "beneficial" in 62.3% and "detrimental" in 7.8% of cases.

CONCLUSION: The high rate of local recurrence may be thought not to justify this treatment. Nevertheless, many patients avoided surgery and remained free of disease. Therefore, this approach deserves further study in the era of immune checkpoints inhibitors.