Specimen-Based Resection Margins and Local Control during Transoral Robotic Surgery for Oropharyngeal HPV-Mediated Squamous Cell Carcinoma.

Autor:	Magliocca KR; Department of Pathology, Emory University, Atlanta, Georgia, USA.; Winship Cancer Institute, Emory University, Atlanta, Georgia, USA., Kaka AS; Winship Cancer Institute, Emory University, Atlanta, Georgia, USA.; Department of Otolaryngology, Emory University, Atlanta, Georgia, USA., Barrow EM; Department of Otolaryngology, Emory University, Atlanta, Georgia, USA., Studer MB; Emory University School of Medicine, Atlanta, Georgia, USA.; Department of Otolaryngology, Oregon Health & Science University, Portland, Oregon, USA., Griffith CC; Department of Pathology, Cleveland Clinic, Cleveland, Ohio, USA., Ernst J; Department of Pathology, Emory University, Atlanta, Georgia, USA., Meade T; Department of Pathology, Emory University, Atlanta, Georgia, USA., Balicki A; Department of Pathology, Emory University, Atlanta, Georgia, USA., Boyce BJ; Winship Cancer Institute, Emory University, Atlanta, Georgia, USA.; Department of Otolaryngology, Emory University, Atlanta, Georgia, USA., Schmitt NC; Winship Cancer Institute, Emory University, Atlanta, Georgia, USA.; Department of Otolaryngology, Emory University, Atlanta, Georgia, USA., Bur AM; Department of Otolaryngology, University of Kansas, Kansas, Missouri, USA., Schmitt AC; Department of Pathology, Mayo Clinic, Scottsdale, Arizona, USA., Jackson R; Department of Otolaryngology, Washington University, St. Louis, Missouri, USA., Steuer CE; Winship Cancer Institute, Emory University, Atlanta, Georgia, USA., Beitler JJ; Winship Cancer Institute, Emory University, Atlanta, Georgia, USA.; Department of Otolaryngology, Emory University, Atlanta, Georgia, USA.; Department of Radiation Oncology, Emory University, Atlanta, Georgia, USA., Patel MR; Winship Cancer Institute, Emory University, Atlanta, Georgia, USA.; Department of Otolaryngology, Emory University, Atlanta, Georgia, USA.
Jazyk:	angličtina
Zdroj:	ORL; journal for oto-rhino-laryngology and its related specialties [ORL J Otorhinolaryngol Relat Spec] 2023; Vol. 85 (2), pp. 80-87. Date of Electronic Publication: 2022 Dec 20.
DOI:	10.1159/000527369
Abstrakt:	Objectives: The aim of the study was to investigate the association of surgical margin conditions, including positive specimen margins revised to negative relative to local recurrence, disease-free survival, and overall survival (OS) within a cohort of HPV-mediated oropharyngeal squamous cell carcinoma (OPSCC) who underwent en bloc resection via transoral robotic surgery (TORS). Materials and Methods: Retrospective cohort of patients with untreated HPV-mediated OPSCC cT1 or T2 undergoing TORS resection between October 2014 and March 2020. The methodologic description of our interdisciplinary institutional approach, number of cut-through margins (CTMs) during intraoperative consultation, percentage of final positive margin cases, and disease-free survival and OS stratified by margin status and margin tumor-free distance is identified. Results: 135 patients with primary cT1/T2 HPV-mediated OPSCC met inclusion criteria. Twenty-eight of 135 (20.7%) specimens revealed CTM and were revised during the same operative setting. Three of 135 (2.2%) surgical cases had positive final margin status. Local control rate was 97%. On univariate analysis, margin distance did not impact OS. CTM and final positive margins had lower OS than initially negative margins (p = 0.044). Pathologic N-stage significantly impacted OS (p < 0.001). Conclusions: High local control rate and low final positive margin status confound the study of specimen margin-based techniques in HPV-mediated OPSCC resected en bloc with TORS. Pathologic N-stage may impact OS more than margin status. Larger numbers are needed to confirm differences. (© 2022 S. Karger AG, Basel.)
Databáze:	MEDLINE
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