Long-term Functional and Oncologic Results of Transoral Robotic Surgery for Oropharyngeal Squamous Cell Carcinoma

• Published in: Mayo Clinic proceedings Vol. 87; no. 3; pp. 219 - 225
• Main Authors: Moore, Eric J., MD, Olsen, Steven M., MD, Laborde, Rebecca R., PhD, García, Joaquín J., MD, Walsh, Francis J., BA, Price, Daniel L., MD, Janus, Jeffrey R., MD, Kasperbauer, Jan L., MD, Olsen, Kerry D., MD
• Format: Journal Article
• Language: English
• Published: Rochester, MN Elsevier Inc 01-03-2012; Mayo Foundation; Elsevier, Inc; Elsevier Limited
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Cancer; Carcinoma, Squamous Cell - etiology; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - surgery; Care and treatment; Chemotherapy; Development and progression; Female; General aspects; Health aspects; Humans; Internal Medicine; Kaplan-Meier Estimate; Male; Medical sciences; Middle Aged; Neoplasm Staging; Original; Oropharyngeal Neoplasms - etiology; Oropharyngeal Neoplasms - pathology; Oropharyngeal Neoplasms - surgery; Otorhinolaryngology. Stomatology; Papillomavirus Infections - complications; Prognosis; Risk Factors; Robotic surgery; Robotics - methods; Smoking - adverse effects; Squamous cell carcinoma; Treatment Outcome; Tumors; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology; United States; Oropharynx cancer; Malignant tumor; Long term; Robotics; Result; Medicine; Oropharynx squamous cell carcinoma; Treatment; Telemedicine; Surgery; ENT disease; Pharynx disease; Cancer
• ISSN: 0025-6196; 1942-5546
• DOI: 10.1016/j.mayocp.2011.10.007

Abstract Objective To examine the long-term functional and oncologic results in patients who underwent transoral robotic surgery (TORS) as primary therapy or as part of combined therapy for oropharyngeal squamous cell carcinoma arising in the tonsil or base of tongue. Patients and Methods We reviewed a prospective TORS database of patients with squamous cell carcinoma arising in the tonsil or base of tongue treated between March 2007 and February 2009 to determine oncologic outcomes at 24 months or more of follow-up. The presenting tumor stage, histopathologic factors, surgical margins, and adjuvant treatment extent were evaluated. Functional outcomes included gastrostomy tube dependence and tracheostomy dependence. Oncologic outcomes included local, regional, and distant control and disease-specific and recurrence-free survival. Results A total of 66 TORS patients were followed up for a minimum of 2 years. Most (97.0%; 64 of 66) were able to eat orally within 3 weeks after surgery before starting adjuvant therapy. Long-term gastrostomy tube use was required in 3 of the 66 (4.5%) and long-term tracheotomy in 1 (1.5%). Three-year estimated local control and regional control were 97.0% and 94.0%, respectively. Two-year disease-specific survival and recurrence-free survival were 95.1% and 92.4%, respectively. Conclusion With appropriate adjuvant therapy, TORS achieves excellent functional results for patients with oropharyngeal squamous cell carcinoma. Oncologic outcomes are equivalent or superior to results of other surgical and nonsurgical treatments.