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Objective: Evaluate the safety of reduced surgical margins after NAT with tislelizumab and afatinib versus an upfront surgery control by comparing pathological margins. Design: Prospective, single-center pilot cohort. Setting: Tertiary referral center in Western China.",{"@graph":14,"@context":71},[15,34,54],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/surgical-margin-reduction-after-immunotargeted-neoadjuvant-therapy-in-locally-advanced-hypopharyngeal-carcinoma-preliminary-margin-results-from-neochance-1-trial/344658/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":48,"encodingFormat":47,"isAccessibleForFree":49,"interactionStatistic":50},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/surgical-margin-reduction-after-immunotargeted-neoadjuvant-therapy-in-locally-advanced-hypopharyngeal-carcinoma-preliminary-margin-results-from-neochance-1-trial/344658.png","ImageObject",300,407,{"name":42,"@type":43},"Logic","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-09-22",true,{"@type":51,"interactionType":52,"userInteractionCount":22},"InteractionCounter",{"@type":53},"ViewAction",{"@type":55,"mainEntity":56},"FAQPage",[57,63,67],{"name":58,"@type":59,"acceptedAnswer":60},"What 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Therapy in Locally Advanced Hypopharyngeal Carcinoma: A Preliminary Margin Results from neoCHANCE-1 Trial  \nJournal of Otolaryngology-Head & Neck Surgery  \nVolume 55: 1–10  \n© The Author(s) 2026  \nArticle reuse guidelines: [sagepub.com/journals-permissions](sagepub.com/journals-permissions)[ ](sagepub.com/journals-permissions)[DOI: 10.1177/19160216251415526](DOI: 10.1177/19160216251415526)[ ](DOI: 10.1177/19160216251415526)[journals.sagepub.com/home/ohn](journals.sagepub.com/home/ohn)  \nDejuan Wang, MD1 ,2*, Jixing Wei, MD3*, Zheng Jiang, MD, MPH 1 ,2,3*,  \nZhigong Wei, MD, PhD3*, Mailudan Ainiwaer, MD 1 ,2, Pengwei Zhao, MD 1 ,2, Lixiao Fan, MD 1 ,2, Longhao Wang, MD, PhD 1 ,2, Leyu Li, MD 1 ,2, Dapeng Lei, MD, PhD4, Fei Chen, MD, PhD 1 ,2, Huijiao Chen, MD, PhD5, Xingchen Peng, MD, PhD3,  \nand Jun Liu, MD, PhD 1 ,2  \nAbstract  \nImportance. 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.  \nObjective. 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.  \nDesign. Prospective, single-center pilot cohort study.  \nSetting. Tertiary referral center in Western China.  \nParticipants. Forty-one patients with locally advanced HPSCC; 32 received NAT (treatment group), and 9 served as an upfront surgery control group.  \nIntervention 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.  \nMain 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.  \nResults. 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 the treatment group versus control (2.09 mm vs 1.04 mm; 95% CI: 0.12-1.97; P = .029).  \nConclusions. Combined immune-targeted NAT effectively downstages HPSCC. The significantly larger pathological margins observed support that reducing clinical surgical margins after this regimen is generally safe.  \nRelevance. This NAT regimen may allow for less extensive resections, facilitating laryngeal preservation and improving quality of life without compromising oncologic safety. Larger validation studies are needed.  \nKeywords  \nhypopharyngeal cancer, surgical margin, neoadjuvant therapy, PD-1, EGFR  \nReceived September 6, 2025; accepted December 21, 2025.  \nCreative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial  \n4.0 License ([https://creativecommons.org/licenses/by-nc/4.0/](https://creativecommons.org/licenses/by-nc/4.0/)) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ([https://us.sagepub.com/en-us/nam/open-access-at-sage](https://us.sagepub.com/en-us/nam/open-access-at-sage)).  \nGraphical Abstract  \n1 Department of Otolaryngology—Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu, China  \n2Head and Neck Surgical Center, West China Hospital, Sichuan University, Chengdu, China 3Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, China 4Department of Otorhinolaryngology, Qilu Hosp","cbCaihJKQqycoXDv","https://ap.wps.com/l/cbCaihJKQqycoXDv","pdf",1669071,"English","# Abstract\n## Importance\n## Objective\n## Design\n## Setting\n## Participants\n## Intervention or Exposures\n## Main Outcome Measures\n## Results\n## Conclusions\n## Relevance\n# Key Messages\n## Pathological response and outcomes\n## Margin findings\n## Clinical implications","[{\"question\":\"What clinical question does the neoCHANCE-1 study address?\",\"answer\":\"It evaluates whether reducing surgical margins after neoadjuvant therapy with tislelizumab plus afatinib is safe by comparing pathological margin outcomes with an upfront surgery control group.\"},{\"question\":\"How was neoadjuvant therapy administered in the treatment group?\",\"answer\":\"Patients received 2 cycles of neoadjuvant tislelizumab combined with 6 weeks of afatinib before surgery.\"},{\"question\":\"What were the main margin findings between groups?\",\"answer\":\"Compared with the upfront surgery group, the NAT group showed significantly larger minimal peripheral surgical margin (3.38 mm vs 1.71 mm) and minimal deep surgical margin (2.09 mm vs 1.04 mm), supporting the safety of margin reduction after this regimen.\"}]","Surgical Margin Reduction After Immunotargeted Neoadjuvant Therapy in Locally Advanced Hypopharyngeal Carcinoma - Preliminary Margin Results from neoCHANCE-1 Trial | PDF",1790054778,25]