Vinidh Paleri1, Hannah Fox2, Sarah Coward3, Maniram Ragbir4, Andrew McQueen5, Omar Ahmed4, David Meikle2, Daniel Saleh4, James O'Hara2, Max Robinson6. 1. Head and Neck Unit, The Royal Marsden Hospitals NHS Foundation Trust and Institute of Cancer Research, London, UK. 2. Department of Otolaryngology - Head and Neck Surgery, Newcastle upon Tyne Hospitals, Newcastle upon Tyne, UK. 3. Department of Speech and Language Therapy, Otolaryngology - Head and Neck Surgery, Newcastle upon Tyne Hospitals, Newcastle upon Tyne, UK. 4. Department of Plastic and Reconstructive Surgery, Newcastle upon Tyne Hospitals, Newcastle upon Tyne, UK. 5. Department of Radiology, Newcastle upon Tyne Hospitals, Newcastle upon Tyne, UK. 6. Department of Pathology, Newcastle upon Tyne Hospitals, Newcastle upon Tyne, UK.
Abstract
BACKGROUND: The purpose of this study was to identify the role of transoral robotic surgery (TORS) in the management of residual and recurrent oropharyngeal cancer. METHODS: IDEAL (Idea, Development, Exploration, Assessment, Long-term Follow-up) 2a framework. RESULTS: Of 26 patients assessed for TORS, 21 underwent the procedure, 5 underwent open resection (4 due to unsuitable anatomy/tumor extent and 1 on the basis of patient choice). Three patients underwent intraoperative ultrasound-assisted robotic resection, and 3 received robotic-assisted free flap inset. A technical refinement for TORS of residual and recurrent oropharyngeal cancer of the tongue base is described. Actuarial plots showed estimated overall survival of 48.2%, local control of 76.6%, and disease-specific survival of 77.1% at 42.6 months. CONCLUSION: TORS is a valid management option for residual and recurrent oropharyngeal cancer. Oncologic outcomes are comparable to open surgery and transoral laser microsurgery, with the added advantages of en bloc resections, facility for intraoperative ultrasound imaging, and inset of free flaps without mandibular split.
BACKGROUND: The purpose of this study was to identify the role of transoral robotic surgery (TORS) in the management of residual and recurrent oropharyngeal cancer. METHODS: IDEAL (Idea, Development, Exploration, Assessment, Long-term Follow-up) 2a framework. RESULTS: Of 26 patients assessed for TORS, 21 underwent the procedure, 5 underwent open resection (4 due to unsuitable anatomy/tumor extent and 1 on the basis of patient choice). Three patients underwent intraoperative ultrasound-assisted robotic resection, and 3 received robotic-assisted free flap inset. A technical refinement for TORS of residual and recurrent oropharyngeal cancer of the tongue base is described. Actuarial plots showed estimated overall survival of 48.2%, local control of 76.6%, and disease-specific survival of 77.1% at 42.6 months. CONCLUSION: TORS is a valid management option for residual and recurrent oropharyngeal cancer. Oncologic outcomes are comparable to open surgery and transoral laser microsurgery, with the added advantages of en bloc resections, facility for intraoperative ultrasound imaging, and inset of free flaps without mandibular split.
Authors: Khairil Afif Mahmud; Fatin Nurul Fariha Ghazali; Muhammad Nur Islam Zahari; Haizlene Abd Halim; Ahmad Kusyairi Khalid; Song Tar Toh; Mohd Razif Mohamad Yunus Journal: J Robot Surg Date: 2022-10-01