Review

. 2025 May;26(5):e264-e281.

doi: 10.1016/S1470-2045(25)00020-8.

International consensus on laryngeal preservation strategies in laryngeal and hypopharyngeal cancer

Marco Ferrari¹, Francesca Mularoni², Davide Smussi³, Piergiorgio Gaudioso⁴, Pierluigi Bonomo⁵, Jeppe Friborg⁶, Maria Grazia Ghi⁷, Vincent Gregoire⁸, Kevin Harrington⁹, Keith Hunter¹⁰, Roberto Maroldi¹¹, Rosemary Martino¹², Ricard Mesia¹³, Giorgio Peretti¹⁴, Amanda Psyrri¹⁵, Antonio Schindler¹⁶, Giovanni Succo¹⁷, Petr Szturz¹⁸, Isabel Vilaseca¹⁹, Piero Nicolai²⁰, Paolo Bossi²¹; Consensus Group for Laryngeal Preservation

Collaborators, Affiliations

Collaborators

Consensus Group for Laryngeal Preservation:
Jai Prakash Agarwal, Mohssen Ansarin, Athanassios Argiris, Panagiotis Balermpas, Nicolò Matteo Luca Battisti, Elisa Bellini, Andy Bertolin, Andrea Luigi Camillo Carobbio, Carlos Miguel Chiesa-Estomba, Beatriz Cirauqui, Erika Crosetti, Thiago Bueno De Oliveira, Alberto Deganello, Andreas Dietz, Jesper Grau Eriksen, Antoine Eskander, Nicolas Fakhry, Agustin Falco, Davide Farina, Renata Ferrarotto, Ciro Franzese, Sarbani Ghosh Laskar, Wojciech Golusiński, Ehab Yn Hanna, Jonathan Crawford Irish, Naomi Kiyota, Luiz Paulo Kowalski, Suren Krishnan, Nancy Lee, C René Leemans, Lisa Licitra, Laura Deborah Locati, Jean-Pascal Machiels, Filippo Marchi, Davide Mattavelli, Hisham Mehanna, Giuseppe Mercante, Nausica Montalto, Patrizia Morbini, Brian O'Sullivan, Marc Oliva, Ester Orlandi, Alberto Paderno, Vinidh Paleri, Frank Pameijer, Francesco Perri, Roberto Persio, Cesare Piazza, Yoann Pointreau, Livio Presutti, Marco Ravanelli, Danny Rischin, Juan Pablo Rodrigo, Alessandra Ruaro, Giuseppe Sanguineti, Christian Simon, Lillian Siu, Anna Spreafico, Giuseppe Spriano, Stefano Taboni, Umberto Tassini, Silke Tribius, Michiel Van den Brekel, Vincent Vander Poorten, David Viros Porcuna

Affiliations

¹ Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neuroscience, University of Padova, Padova, Italy; Unit of Otorhinolaryngology-Head and Neck Surgery, Padua University Hospital, Padova, Italy; Guided Therapeutics Program International Scholarship, University Health Network, Toronto, ON, Canada. Electronic address: marco.ferrari@unipd.it.
² Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neuroscience, University of Padova, Padova, Italy.
³ Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy; Unit of Medical Oncology, ASST Spedali Civili di Brescia, Brescia, Italy.
⁴ Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neuroscience, University of Padova, Padova, Italy; Unit of Otorhinolaryngology-Head and Neck Surgery, Padua University Hospital, Padova, Italy; Department of Surgery Oncology and Gastroenterology, University of Padova, Padova, Italy.
⁵ Radiation Oncology, Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
⁶ Department of Oncology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
⁷ Unit of Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy.
⁸ Department of Radiation Oncology, Centre Léon Bérard, Lyon, France.
⁹ The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK.
¹⁰ Liverpool Head and Neck Centre, Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK.
¹¹ Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
¹² Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada; Speech-Language Pathology, University of Toronto, Toronto, ON, Canada; Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON, Canada; Krembil Research Institute, University Health Network, Toronto, ON, Canada.
¹³ Medical Oncology Department, Catalan Institute of Oncology, Badalona, Spain.
¹⁴ Unit of Otorhinolaryngology-Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Surgical Science, University of Genoa, Genoa, Italy.
¹⁵ Section of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece.
¹⁶ Department of Biomedical and Clinical Science, University of Milan, Milan, Italy.
¹⁷ Department of Oncology, University of Turin, Turin, Italy; Otorhinolaryngology Clinic - Head and Neck Cancer Unit, San Giovanni Bosco Hospital, Turin, Italy.
¹⁸ Department of Oncology, University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland.
¹⁹ Department of Otolaryngology, Hospital Clínic, Barcelona, Spain; Unit of Head and Neck Tumors, Hospital Clínic, Barcelona, Spain; Translational Genomics and Target Therapies in Solid Tumors Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; Faculty of Medicine, University of Barcelona, Barcelona, Spain.
²⁰ Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neuroscience, University of Padova, Padova, Italy; Unit of Otorhinolaryngology-Head and Neck Surgery, Padua University Hospital, Padova, Italy.
²¹ Department of Biomedical Sciences, Humanitas University, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy. Electronic address: paolo.bossi@hunimed.eu.

PMID: 40318658
DOI: 10.1016/S1470-2045(25)00020-8

Review

International consensus on laryngeal preservation strategies in laryngeal and hypopharyngeal cancer

Marco Ferrari et al. Lancet Oncol. 2025 May.

. 2025 May;26(5):e264-e281.

doi: 10.1016/S1470-2045(25)00020-8.

Authors

Collaborators

Consensus Group for Laryngeal Preservation:
Jai Prakash Agarwal, Mohssen Ansarin, Athanassios Argiris, Panagiotis Balermpas, Nicolò Matteo Luca Battisti, Elisa Bellini, Andy Bertolin, Andrea Luigi Camillo Carobbio, Carlos Miguel Chiesa-Estomba, Beatriz Cirauqui, Erika Crosetti, Thiago Bueno De Oliveira, Alberto Deganello, Andreas Dietz, Jesper Grau Eriksen, Antoine Eskander, Nicolas Fakhry, Agustin Falco, Davide Farina, Renata Ferrarotto, Ciro Franzese, Sarbani Ghosh Laskar, Wojciech Golusiński, Ehab Yn Hanna, Jonathan Crawford Irish, Naomi Kiyota, Luiz Paulo Kowalski, Suren Krishnan, Nancy Lee, C René Leemans, Lisa Licitra, Laura Deborah Locati, Jean-Pascal Machiels, Filippo Marchi, Davide Mattavelli, Hisham Mehanna, Giuseppe Mercante, Nausica Montalto, Patrizia Morbini, Brian O'Sullivan, Marc Oliva, Ester Orlandi, Alberto Paderno, Vinidh Paleri, Frank Pameijer, Francesco Perri, Roberto Persio, Cesare Piazza, Yoann Pointreau, Livio Presutti, Marco Ravanelli, Danny Rischin, Juan Pablo Rodrigo, Alessandra Ruaro, Giuseppe Sanguineti, Christian Simon, Lillian Siu, Anna Spreafico, Giuseppe Spriano, Stefano Taboni, Umberto Tassini, Silke Tribius, Michiel Van den Brekel, Vincent Vander Poorten, David Viros Porcuna

Affiliations

¹ Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neuroscience, University of Padova, Padova, Italy; Unit of Otorhinolaryngology-Head and Neck Surgery, Padua University Hospital, Padova, Italy; Guided Therapeutics Program International Scholarship, University Health Network, Toronto, ON, Canada. Electronic address: marco.ferrari@unipd.it.
² Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neuroscience, University of Padova, Padova, Italy.
³ Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy; Unit of Medical Oncology, ASST Spedali Civili di Brescia, Brescia, Italy.
⁴ Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neuroscience, University of Padova, Padova, Italy; Unit of Otorhinolaryngology-Head and Neck Surgery, Padua University Hospital, Padova, Italy; Department of Surgery Oncology and Gastroenterology, University of Padova, Padova, Italy.
⁵ Radiation Oncology, Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
⁶ Department of Oncology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
⁷ Unit of Oncology 2, Istituto Oncologico Veneto IRCCS, Padova, Italy.
⁸ Department of Radiation Oncology, Centre Léon Bérard, Lyon, France.
⁹ The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK.
¹⁰ Liverpool Head and Neck Centre, Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK.
¹¹ Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
¹² Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada; Speech-Language Pathology, University of Toronto, Toronto, ON, Canada; Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON, Canada; Krembil Research Institute, University Health Network, Toronto, ON, Canada.
¹³ Medical Oncology Department, Catalan Institute of Oncology, Badalona, Spain.
¹⁴ Unit of Otorhinolaryngology-Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Surgical Science, University of Genoa, Genoa, Italy.
¹⁵ Section of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece.
¹⁶ Department of Biomedical and Clinical Science, University of Milan, Milan, Italy.
¹⁷ Department of Oncology, University of Turin, Turin, Italy; Otorhinolaryngology Clinic - Head and Neck Cancer Unit, San Giovanni Bosco Hospital, Turin, Italy.
¹⁸ Department of Oncology, University of Lausanne and Lausanne University Hospital, Lausanne, Switzerland.
¹⁹ Department of Otolaryngology, Hospital Clínic, Barcelona, Spain; Unit of Head and Neck Tumors, Hospital Clínic, Barcelona, Spain; Translational Genomics and Target Therapies in Solid Tumors Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; Faculty of Medicine, University of Barcelona, Barcelona, Spain.
²⁰ Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neuroscience, University of Padova, Padova, Italy; Unit of Otorhinolaryngology-Head and Neck Surgery, Padua University Hospital, Padova, Italy.
²¹ Department of Biomedical Sciences, Humanitas University, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy. Electronic address: paolo.bossi@hunimed.eu.

PMID: 40318658
DOI: 10.1016/S1470-2045(25)00020-8

Abstract

This Policy Review summarises an expert Delphi consensus process on larynx-preservation treatments in patients affected by intermediate-to-advanced laryngeal or hypopharyngeal squamous cell carcinoma. The experts, who represented all perspectives involved in multidisciplinary management of these patients and included patient representatives, approved 137 consensus statements that cover several relevant areas in the field of larynx-preserving treatments. Statements are grouped in the following topics: granular indications for T2-T3 cancer, indications for T4a cancer, indications for salvage organ-preservation surgery after chemoradiation failure, laryngeal function at baseline, which comorbidities are contraindications and to what extent, organ preservation in older patients: selection criteria, post-treatment surveillance, prognostic and predictive factors, listening to the patient's preferences: tools and implementation, prehabilitation and rehabilitation protocols, and cost-effectiveness of different laryngeal preservation approaches. We present a high-level summary of the results of the consensus process, with detailed reference to the full list of statements and supporting literature.

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Conflict of interest statement

Declaration of interests MF reports support for attending meetings or travel from Atos, Medtronic, Audionova, and Amplifon. JF reports grants or contracts from Varian Medical Systems and reports being a board member of European Head and Neck Society. KHa reports grants or contracts from AstraZeneca, Boehringer-Ingelheim, and Replimune; reports consulting fees from ALX Oncology, AstraZeneca, Bicara, Boehringer-Ingelheim, Bristol Myers Squibb (BMS), Exelixis, GlaxoSmithKline (GSK), ISA Pharma, Merck, Merck Sharp & Dohme (MSD), QBiotics, and Replimune; reports payment or honoraria from Merck; and reports support for attending meetings or travel from Merck. RMa reports grants or contracts from the Patient-Centered Outcomes Research Institute 1609–36195 The Princess Margaret Cancer Foundation, Innovation Funds for Surgical Oncology, Canadian Cancer Society Research Institute–Innovation to Impact Grant, the US National Cancer Institute and NRG Oncology (NCT02254278), and US National Institutes of Health (NIH) R01 DC017291–01; and reports support for attending meetings or travel from Gleiberman Head and Neck Cancer Center Advisory Council, Studio Progress. RMe reports payment or honoraria from Roche, Merck, and MSD; reports support for attending meetings or travel from MSD and Merck; and reports participation on a Data Safety Monitoring Board or Advisory Board for Pfizer, MSD, Roche, Merck, and GSK. AP reports grants or contracts from MSD, KURA, WinMedica, Pfizer, and Roche; reports consulting fees from MSD, BMS, Merck Serono, Merus, Seagen, GSK, AstraZeneca, and Pfizer; reports payment or honoraria from MSD, BMS, Merck Serono, Roche, and AstraZeneca; support for attending meetings or travel from MSD, Genesis, and Ipsen; participation on a Data Safety Monitoring Board or Advisory Board for ISA therapeutics; reports leadership or fiduciary role in Hellenic Cooperative Oncology Group, Hellenic Society of Head and Neck Cancer, and European Society for Medical Oncology; and receipt of equipment, materials, drugs, medical writing, gifts, or other services from DEMO. PS reports institutional payment or honoraria from Merck–Serono and Servier; reports support for attending meetings or travel from Merck-Serono; reports participation on a Data Safety Monitoring Board or Advisory Board for University of Birmingham and Groupe d'Oncologie Radiothérapie Tête Et Cou; and reports leadership or fiduciary role in the European Organisation for Research and Treatment of Cancer and the Head & Neck Cancer International Group. IV reports payment or honoraria from Olympus and Storz. PN reports support for attending meetings or travel from Atos and Amplifon. PBos reports payment or honoraria from Merck, Sanofi–Regeneron, MSD, Daiichi–Sankyo, GSK, Merus, Sun Pharma, Pfizer, Genmab, Angelini, Nestlè, and Nutricia. All other authors declare no competing interests. Competing interests for all other members of the Consensus Group for Laryngeal Preservation are presented in the appendix (pp 91–92).

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International consensus on laryngeal preservation strategies in laryngeal and hypopharyngeal cancer

Collaborators

Affiliations

International consensus on laryngeal preservation strategies in laryngeal and hypopharyngeal cancer

Authors

Collaborators

Affiliations

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Conflict of interest statement

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