Surgical Margin Reduction After Immunotargeted Neoadjuvant Therapy in Locally Advanced Hypopharyngeal Carcinoma: A Preliminary Margin Results from neoCHANCE-1 Trial

作者：D Wang, Jixing Wei, Zheng Jiang, Zhigong Wei, Mailudan Ainiwaer, Pengwei Zhao, Lixiao Fan, Longhao Wang, Leyu Li, Dapeng Lei, F Chen, Huijiao Chen, Xingchen Peng, Jun Liu · 发表于：Journal of Otolaryngology - Head and Neck Surgery · 年份：2026 · DOI：10.1177/19160216251415526 · 被引用次数：1 · 研究领域：Head and Neck Cancer Studies、Esophageal Cancer Research and Treatment、Colorectal and Anal Carcinomas

Importance Hypopharyngeal squamous cell carcinoma (HPSCC) is an aggressive cancer with poor outcomes. Neoadjuvant therapy (NAT) may allow organ preservation, but determining safe surgical margins after NAT is a critical challenge. Objective To evaluate the safety of reduced surgical margins after neoadjuvant tislelizumab and afatinib in locally advanced HPSCC by comparing pathological margins to an upfront surgery control group. Design Prospective, single-center pilot cohort study. Setting Tertiary referral center in Western China. Participants Forty-one patients with locally advanced HPSCC; 32 received NAT (treatment group), and 9 served as an upfront surgery control group. Intervention or Exposures Treatment group: 2 cycles of neoadjuvant tislelizumab plus 6 weeks of afatinib. Control group: upfront surgery. Both groups underwent resection with a 1.5 cm naked-eye surgical margin. Main Outcome Measures Primary outcomes were minimal peripheral surgical margin (MPSM) and minimal deep surgical margin (MDSM). Secondary outcomes included radiological (RECIST v1.1) and pathological tumor response. Results The NAT group had a 20/32 (62.5%) radiological objective response rate and a 16/32 (50.0%) major pathological response rate [including 9/32 (28.13%) pathological complete response]. The mean MPSM was significantly greater in the treatment group versus control [3.38 mm vs 1.71 mm; 95% Confidence interval (CI): 0.10-3.24; P = .038]. The mean MDSM was also significantly greater in t...