Decreased gastrostomy tube incidence and weight loss after transoral robotic surgery for low- to intermediate-risk oropharyngeal squamous cell carcinoma

Autor: Neil D. Gross, Amy C. Hessel, Michael E. Kupferman, F. Christopher Holsinger, G. Brandon Gunn, Adam S. Garden, Jan S. Lewin, Katherine A. Hutcheson, Ryan P. Goepfert, Harold Heah, Clifton D. Fuller
Rok vydání: 2018
Předmět:
Adult
Male
Natural Orifice Endoscopic Surgery
medicine.medical_specialty
Multivariate analysis
medicine.medical_treatment
Risk Assessment
Cohort Studies
03 medical and health sciences
Enteral Nutrition
0302 clinical medicine
Robotic Surgical Procedures
Weight loss
Weight Loss
Transoral robotic surgery
medicine
Humans
030223 otorhinolaryngology
Aged
Retrospective Studies
Gastrostomy
business.industry
Incidence
Incidence (epidemiology)
Common Terminology Criteria for Adverse Events
Chemoradiotherapy
Middle Aged
Quality Improvement
Survival Analysis
Surgery
Radiation therapy
Oropharyngeal Neoplasms
Treatment Outcome
Otorhinolaryngology
Oropharyngeal Carcinoma
Gastrostomy tube
030220 oncology & carcinogenesis
Multivariate Analysis
Carcinoma
Squamous Cell
Regression Analysis
Female
medicine.symptom
business
Follow-Up Studies
Zdroj: Head & Neck. 40:2507-2513
ISSN: 1043-3074
DOI: 10.1002/hed.25382
Popis: Background Functional outcomes after treatment for oropharyngeal squamous cell carcinoma (SCC) are increasingly prioritized. The purpose of this study was to investigate the incidence of gastrostomy tube placement and weight loss in patients with oropharyngeal SCC who may be eligible for either transoral robotic surgery (TORS) or nonsurgical management. Methods We conducted a retrospective review of previously untreated T1 to T2 and N0 to N2b oropharyngeal SCC to determine the rates of gastrostomy tube placement and weight loss according to Common Terminology Criteria for Adverse Events (CTCAE) criteria. Multivariate regression models were fit to compare these end points between groups. Results Two hundred twenty-three patients were included, comprised of 66 patients who underwent TORS and 157 patients who underwent (chemo)radiation. Thirty-two (48.5%) of the TORS patients received adjuvant radiation. On multivariate analysis, patients treated nonsurgically were 10.6 times and 8.1 times more likely to receive a gastrostomy tube and experience greater than CTCAE grade 1 weight loss, respectively. Conclusion In selected patients with oropharyngeal SCC, TORS may help avoid critical weight loss and gastrostomy tube placement in the acute treatment period.
Databáze: OpenAIRE
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