Transoral robotic surgery for squamous cell carcinoma of the oropharynx in a primarily human papillomavirus-negative patient population

Autor: C. Pollan Guisasola, B. Cirauqui Cirauqui, L Pardo Muñoz, C. Viña Soria, D. Viros Porcuna, F Collurá, R. Mesia Nin
Rok vydání: 2020
Předmět:
0301 basic medicine
Adult
Male
Cancer Research
medicine.medical_specialty
Reconstructive surgery
Population
Alphapapillomavirus
Head and neck cancer
Oropharyngeal cancer
Reconstructive surgery
Salvage surgery
Squamous cell carcinoma
TORS
03 medical and health sciences
0302 clinical medicine
Robotic Surgical Procedures
Transoral robotic surgery
medicine
Humans
Stage (cooking)
education
Aged
Retrospective Studies
Aged
80 and over
Salvage Therapy
education.field_of_study
Mouth
business.industry
Squamous Cell Carcinoma of Head and Neck
Incidence (epidemiology)
Head and neck cancer
Cancer
Human Papillomavirus Negative
General Medicine
Middle Aged
medicine.disease
Surgery
Deglutition
Oropharyngeal Neoplasms
030104 developmental biology
Oncology
030220 oncology & carcinogenesis
Female
business
Negative Results
Zdroj: CLINICAL & TRANSLATIONAL ONCOLOGY
r-IGTP: Repositorio Institucional de Producción Científica del Instituto de Investigación Germans Trias i Pujol
Institut de Recerca Germans Trias i Pujol (IGTP)
r-IGTP. Repositorio Institucional de Producción Científica del Instituto de Investigación Germans Trias i Pujol
instname
ISSN: 1699-048X
Popis: Transoral robotic surgery (TORS) is one of the main treatment options for non-locally advanced primary oropharyngeal cancer in the United States. However, its use is more limited in countries with a low incidence of human papillomavirus (HPV), such as Spain, in patients with advanced disease, and as salvage surgery. To shed light on the use and potential benefit of TORS in Spanish patients, we analyzed the functional and oncologic outcomes of TORS as both primary and salvage surgery in a primarily HPV-negative population which is representative of oropharyngeal squamous cell carcinoma (OPSCC) patients in Spain. This is a retrospective analysis of prospectively collected data on OPSCC patients treated with TORS at our center between February 2017 and February 2019. Fifty-four OPSCC patients were included; 79.6% were males and 80.5% were HPV negative. Median age was 62 years. Primary surgery was performed on 73.7% (48.1% stage I–II; 51.9% stage III–IV) and salvage surgery on 25.9% of patients. Positive margin rates were 4.3% for T1–2 and 25.8% for T3–4. None of the stage I–II patients and 27.7% of stage III–IV patients required adjuvant treatment. Reconstructive surgery was performed in 19.2% of all patients. Normal swallowing was achieved in 92.7% of patients at 6 months after surgery. 1- and 2-year survival rates for all patients were 94.5% and 89%, respectively. The overall complication rate was 16.1%. Bleeding occurred in 11.5% of patients. Longer hospitalization time was associated with surgical complications (P = 0.03) and reconstructive surgery (P = 0.03) but not with salvage surgery. TORS is a safe and effective treatment for HPV-negative T1–2 OPSCC patients. The positive margin rate was worse in T3–4 patients, indicating the need for careful patient selection in this subgroup.
Databáze: OpenAIRE
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