Long‐Term Outcomes of End‐Flexible‐Rigidscopic Transoral Surgery for Pharyngolaryngeal Cancer

Objective End‐flexible‐rigidscopic transoral surgery (E‐TOS) is a new and minimally invasive transoral surgery for resection of Tis‐selected T3 pharyngolaryngeal cancers. We evaluated long‐term oncological outcomes and whether postoperative voice and swallowing function were preserved following E‐TOS. Methods In this retrospective single‐center study, 154 patients treated with E‐TOS using a curved retractor, flexible‐tip rigid endoscope, and thin curved instruments were included. Their survival rate, larynx preservation rate, and disease control rate were estimated using the Kaplan–Meier method. Postoperative voice function was evaluated using both objective and subjective tests. Postoperative swallowing function was assessed using the Hyodo score and the functional outcome swallowing scale. Results The 3‐year and 5‐year overall survival, disease‐specific survival, disease‐free survival, laryngectomy‐free survival, local control, and loco‐regional control rates post E‐TOS were 89.8% and 82.2%, 95.6% and 92.3%, 78.5% and 70.3%, 87.2% and 80.9%, 93.9% and 92.5%, and 87.2% and 85.7%, respectively. Both objective and subjective postoperative voice and swallowing function tests were within normal limits in more than 90% of the patients. Conclusion E‐TOS is an effective, safe, low‐cost, and minimally invasive transoral surgery for Tis‐selected T3 pharyngolaryngeal cancer; it also preserves postoperative voice, larynx, and swallowing function. Level of Evidence 4 Laryngoscope, 133:1415–1424, 2023 End‐flexible‐rigidscopic transoral surgery (E‐TOS) is a safe procedure for pharyngolaryngeal cancer resection, with a low postoperative complication rate. E‐TOS provides excellent oncological outcomes and functional preservation.