Kate Kelly1, Stephanie Johnson-Obaseki2, Julie Lumingu3, Martin Corsten4. 1. Department of Otolaryngology-Head & Neck Surgery, University of Ottawa, Ottawa, Canada. 2. FRCSC, Department of Otolaryngology-Head & Neck Surgery, University of Ottawa, Ottawa, Canada. Electronic address: sjohnsonobaseki@gmail.com. 3. University of Ottawa, Ottawa, Canada. 4. FRCSC, Department of Neurosciences/Otolaryngology-Head and Neck Surgery, Aurora St. Luke's Hospital, Milwaukee, WI, United States.
Abstract
OBJECTIVES: Transoral Robotic Surgery (TORS) has emerged as an alternative to radiotherapy or chemoradiotherapy for the treatment of oropharyngeal squamous cell carcinoma (OPSCC). Many centers restrict the use of TORS to early (T1-2) OPSCC. The purpose of this article was to assess oncologic and functional outcomes of TORS for primary treatment of early OPSCC. STUDY DESIGN: Systematic review. METHODS: A systematic literature search was performed for all relevant English language studies using Embase, Medline, and Pubmed. Our primary outcome measure was local control; secondary outcomes included overall survival (OS) and tracheostomy tube (TT) and gastrostomy tube (GT) dependence rates. Three authors independently extracted study information and analyzed all included articles for quality and bias using the Newcastle-Ottawa Quality Assessment Scale. RESULTS: A total of 206 papers were identified, with 11 meeting the inclusion criteria (190 patients). For T1-2 OPSCC, the aggregate local control rate was 96.3% with an OS rate of 95.0%. Rates of prolonged (>12 month) TT and GT dependence were 0.0% and 5.0% respectively. CONCLUSIONS: This systematic review suggests that TORS offers high rates of disease control with low rates of long-term TT or GT dependence in T1-2 OPSCC. However, further study is needed to compare TORS outcomes to those of traditional therapies.
OBJECTIVES: Transoral Robotic Surgery (TORS) has emerged as an alternative to radiotherapy or chemoradiotherapy for the treatment of oropharyngeal squamous cell carcinoma (OPSCC). Many centers restrict the use of TORS to early (T1-2) OPSCC. The purpose of this article was to assess oncologic and functional outcomes of TORS for primary treatment of early OPSCC. STUDY DESIGN: Systematic review. METHODS: A systematic literature search was performed for all relevant English language studies using Embase, Medline, and Pubmed. Our primary outcome measure was local control; secondary outcomes included overall survival (OS) and tracheostomy tube (TT) and gastrostomy tube (GT) dependence rates. Three authors independently extracted study information and analyzed all included articles for quality and bias using the Newcastle-Ottawa Quality Assessment Scale. RESULTS: A total of 206 papers were identified, with 11 meeting the inclusion criteria (190 patients). For T1-2 OPSCC, the aggregate local control rate was 96.3% with an OS rate of 95.0%. Rates of prolonged (>12 month) TT and GT dependence were 0.0% and 5.0% respectively. CONCLUSIONS: This systematic review suggests that TORS offers high rates of disease control with low rates of long-term TT or GT dependence in T1-2 OPSCC. However, further study is needed to compare TORS outcomes to those of traditional therapies.
Authors: A Hay; J Migliacci; D Karassawa Zanoni; J O Boyle; B Singh; R J Wong; S G Patel; I Ganly Journal: Clin Otolaryngol Date: 2017-12-26 Impact factor: 2.597