Study aid only. Verify against current guidelines, primary literature, staging manuals, and prescribing information before clinical use.

← All algorithms  ·  Related notes →

Larynx & Hypopharynx SCC — Definitive Treatment

Larynx & hypopharynx SCC Larynx — early T1–2 N0 (select T3 N0) larynx-preserving surgery Endoscopic / partial laryngectomy preferred Definitive RT Larynx — locally advanced T3 N0–1 needing total laryngectomy · T3–4a N+ Larynx-preservation concurrent chemoRT (cisplatin) RTOG 91-11 ↗ Total laryngectomy + neck dissection extensive T4a Neoadjuvant pembrolizumab PD-L1 CPS ≥1 — KEYNOTE-689 ↗ Surgery → RT + pembrolizumab (+ cisplatin if ECE / + margin) → adjuvant pembrolizumab Induction chemo (TPF) → chemoRT / RT Hypopharynx — early most T1 N0, select T2 N0 Definitive RT Partial laryngopharyngectomy + neck dissection Hypopharynx — locally advanced T2–3 N0–3 · T1 N+ Induction chemotherapy → chemoRT / surgery Laryngopharyngectomy + neck dissection Neoadjuvant pembrolizumab PD-L1 CPS ≥1, except T2N0 & N3 — KEYNOTE-689 ↗ Surgery → RT + pembrolizumab (+ cisplatin if ECE / + margin) → adjuvant pembrolizumab Concurrent chemoRT (cisplatin) Adjuvant therapy by pathologic risk pN0, no adverse features observe pN1, no other risk consider RT Extranodal extension ± positive margin chemoRT (cisplatin) Positive margin re-resect, or RT / chemoRT Other risk features RT ± concurrent chemo