Treatment of Hypopharyngeal Squamous Cell Carcinoma at Tumour Stage cT4a

This protocol covers locally advanced hypopharyngeal squamous cell carcinoma presenting at tumour stage cT4a, with nodal status ranging from cN0 to cN3 and no distant metastasis (cM0). Both the primary tumour and regional nodes require inclusion in the treatment strategy.

The defining characteristic of this setting is a cT4a primary tumour of the hypopharynx — which may involve laryngeal cartilage invasion — with any nodal burden up to cN3, confirmed to be non-metastatic (cM0). Cartilage invasion at this stage has specific implications for the choice of treatment pathway.

Where induction-based strategies are applied, the primary objective is achieving a complete or partial tumour response. Response assessment after induction directly determines the subsequent management step.

Evidence-based management at this stage encompasses both surgical and combined modality pathways — the specific indications for each, the sequencing of interventions, and the criteria that determine which pathway applies are set out in the full structured protocol.

Full treatment algorithm, pathway criteria, and regimen details are available in the protocol below.