Scott Troob1, Babak Givi2, Macgregor Hodgson3, Alia Mowery3, Neil D Gross4, Peter E Andersen3, Daniel Clayburgh3. 1. Department of Otolaryngology - Head and Neck Surgery, New York Presbyterian / Columbia University Medical Center, New York, New York. 2. Department of Otolaryngology - Head and Surgery, New York University, New York, New York. 3. Department of Otolaryngology - Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon. 4. Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Abstract
BACKGROUND: Assessment of the retropharyngeal lymph nodes is essential in the treatment for oropharyngeal squamous cell carcinoma (SCC). Transoral robotic retropharyngeal lymph node dissection (RPLND) may provide valuable staging information and guide selection of adjuvant therapy in a transoral robotic surgery (TORS) treatment paradigm. METHODS: Outcomes were compared between 30 patients with oropharyngeal SCC with tonsillar primaries undergoing RPLND and 37 stage-matched cases without RPLND. RESULTS: Retropharyngeal metastasis was confirmed in 6 patients undergoing RPLND. Compared with 37 stage-matched controls, there were no differences in length of stay, length of feeding tube dependence, net change in perioperative weight, or rates of hemorrhage and postoperative complications. RPLND altered adjuvant treatment recommendations in 1 of 30 patients. CONCLUSION: RPLND is technically feasible by a purely transoral robotic approach. Its performance is not associated with worse swallowing outcomes or rates of complication. In select patients, RPLND may provide valuable staging information and guide the selection of adjuvant therapy.
BACKGROUND: Assessment of the retropharyngeal lymph nodes is essential in the treatment for oropharyngeal squamous cell carcinoma (SCC). Transoral robotic retropharyngeal lymph node dissection (RPLND) may provide valuable staging information and guide selection of adjuvant therapy in a transoral robotic surgery (TORS) treatment paradigm. METHODS: Outcomes were compared between 30 patients with oropharyngeal SCC with tonsillar primaries undergoing RPLND and 37 stage-matched cases without RPLND. RESULTS: Retropharyngeal metastasis was confirmed in 6 patients undergoing RPLND. Compared with 37 stage-matched controls, there were no differences in length of stay, length of feeding tube dependence, net change in perioperative weight, or rates of hemorrhage and postoperative complications. RPLND altered adjuvant treatment recommendations in 1 of 30 patients. CONCLUSION: RPLND is technically feasible by a purely transoral robotic approach. Its performance is not associated with worse swallowing outcomes or rates of complication. In select patients, RPLND may provide valuable staging information and guide the selection of adjuvant therapy.
Authors: George Garas; Nick J Roland; Jeffrey Lancaster; Matthew Zammit; Victoria A Manon; Katharine Davies; Terry M Jones; Mriganka De; Floyd C Holsinger; Robin J D Prestwich; Jason C Fleming Journal: Ann Surg Oncol Date: 2022-07-16 Impact factor: 4.339
Authors: Felix Boehm; Rene Graesslin; Marie-Nicole Theodoraki; Leon Schild; Jens Greve; Thomas K Hoffmann; Patrick J Schuler Journal: Cancers (Basel) Date: 2021-03-19 Impact factor: 6.639