OBJECTIVES/HYPOTHESIS: Our objective was to determine the safety, feasibility, and the adequacy of surgical margins for transoral robotic surgery (TORS), by reviewing the early results from independent institutional review board-approved clinical trials in three separate institutions. STUDY DESIGN: Pooled Data from Independent Prospective Clinical Trials. METHODS: One hundred ninety-two patients were initially screened, but inadequate exposure did not permit TORS in 13 (6.7%). For two additional patients, TORS was begun but intraoperatively converted to an open procedure. Thus, the intent-to-treat population was 177 patients (average age, 59 years; 81% male), predominantly comprised of tumors arising in the oropharynx (139, 78%) and larynx (26, 15%). TORS was performed for 161 (91%) patients with malignant disease: 153 (95%) with squamous cell carcinoma (T1 [50, 32.7%], T2 [74, 48.4%], T3 [21, 13.7%], T4 [8, 5.2%]), six patients (3.72%) with salivary gland tumors, and two patients with carcinoma in situ. The average follow-up was 345 days. RESULTS: There was no intraoperative mortality or death in the immediate postoperative period. Average estimated blood loss was 83 mL; no patient required transfusion. The rate of positive margins was 4.3%. Twenty-nine patients (16%) experienced 34 serious adverse events that required hospitalization or intervention (grade 3) or were considered life threatening (grade 4, 2.3%). Tracheostomy was performed in 12.4% of all patients (22/177), but only 2.3% had a tracheostomy at last follow-up. For all patients undergoing TORS without previous therapy, the percutaneous endoscopic gastrostomy dependency rate was 5.0%. The average hospital stay was 4.2 days. CONCLUSIONS: Based on this multicenter study, TORS appears to be safe, feasible, and as such play an important role in the multidisciplinary management of head and neck cancer.
OBJECTIVES/HYPOTHESIS: Our objective was to determine the safety, feasibility, and the adequacy of surgical margins for transoral robotic surgery (TORS), by reviewing the early results from independent institutional review board-approved clinical trials in three separate institutions. STUDY DESIGN: Pooled Data from Independent Prospective Clinical Trials. METHODS: One hundred ninety-two patients were initially screened, but inadequate exposure did not permit TORS in 13 (6.7%). For two additional patients, TORS was begun but intraoperatively converted to an open procedure. Thus, the intent-to-treat population was 177 patients (average age, 59 years; 81% male), predominantly comprised of tumors arising in the oropharynx (139, 78%) and larynx (26, 15%). TORS was performed for 161 (91%) patients with malignant disease: 153 (95%) with squamous cell carcinoma (T1 [50, 32.7%], T2 [74, 48.4%], T3 [21, 13.7%], T4 [8, 5.2%]), six patients (3.72%) with salivary gland tumors, and two patients with carcinoma in situ. The average follow-up was 345 days. RESULTS: There was no intraoperative mortality or death in the immediate postoperative period. Average estimated blood loss was 83 mL; no patient required transfusion. The rate of positive margins was 4.3%. Twenty-nine patients (16%) experienced 34 serious adverse events that required hospitalization or intervention (grade 3) or were considered life threatening (grade 4, 2.3%). Tracheostomy was performed in 12.4% of all patients (22/177), but only 2.3% had a tracheostomy at last follow-up. For all patients undergoing TORS without previous therapy, the percutaneous endoscopic gastrostomy dependency rate was 5.0%. The average hospital stay was 4.2 days. CONCLUSIONS: Based on this multicenter study, TORS appears to be safe, feasible, and as such play an important role in the multidisciplinary management of head and neck cancer.
Authors: Lauren Ottenstein; Hannah Cornett; Jeffrey M Switchenko; Meghana Nathan; Susan Thomas; Amanda I Gillespie; Nancy McColloch; Tiffany Barrett; Matthew B Studer; Meghan Brinkman; Azeem S Kaka; Brian J Boyce; Robert L Ferris; Ashley H Aiken; Mark El-Deiry; Jonathan J Beitler; Mihir R Patel Journal: Head Neck Date: 2021-02-05 Impact factor: 3.147
Authors: William G Albergotti; William E Gooding; Mark W Kubik; Mathew Geltzeiler; Seungwon Kim; Umamaheswar Duvvuri; Robert L Ferris Journal: JAMA Otolaryngol Head Neck Surg Date: 2017-06-01 Impact factor: 6.223
Authors: Joseph Zenga; Jasmina Suko; Dorina Kallogjeri; Patrik Pipkorn; Brian Nussenbaum; Ryan S Jackson Journal: Laryngoscope Date: 2017-04-20 Impact factor: 3.325
Authors: Neil D Gross; F Christopher Holsinger; J Scott Magnuson; Umamaheswar Duvvuri; Eric M Genden; Tamer Ah Ghanem; Kathleen L Yaremchuk; David Goldenberg; Matthew C Miller; Eric J Moore; Luc Gt Morris; James Netterville; Gregory S Weinstein; Jeremy Richmon Journal: Head Neck Date: 2016-03-07 Impact factor: 3.147