The Flex robotic system compared to transoral laser microsurgery for the resection of supraglottic carcinomas: first results and preliminary oncologic outcomes.


Journal

European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
ISSN: 1434-4726
Titre abrégé: Eur Arch Otorhinolaryngol
Pays: Germany
ID NLM: 9002937

Informations de publication

Date de publication:
Mar 2020
Historique:
received: 25 09 2019
accepted: 09 12 2019
pubmed: 2 1 2020
medline: 28 4 2021
entrez: 2 1 2020
Statut: ppublish

Résumé

Transoral robotic surgery (TORS) has the potential to improve some inherent disadvantages of transoral laser microsurgery (TLM). Here, we retrospectively assessed the application of the Medrobotics Flex system for the resection of supraglottic carcinomas compared to TLM. 84 patients underwent surgery for supraglottic carcinomas with the Flex robotic system (n = 19, T-stage distribution in %: T1 42, T2 47, T3 11, T4 0) or TLM (n = 65, T-stage distribution in %: T1 40, T2 44, T3 14, T4 2). Clinical and oncologic parameters were compared. All surgeries were successfully completed with the Flex system and tracheostomy rate was 13%. For patients with adequate follow-up, 24-month disease-free survival was 71.4% (n = 5/7) after TORS compared to 64.9% (n = 24/37) after TLM. Local recurrence rates were 0% for TORS and 11% for TLM. Initial results for supraglottic carcinoma resection using the Medrobotics Flex system are encouraging with excellent local tumor control.

Identifiants

pubmed: 31893297
doi: 10.1007/s00405-019-05767-0
pii: 10.1007/s00405-019-05767-0
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

917-924

Références

Steiner W (1988) Experience in endoscopic laser surgery of malignant tumours of the upper aero-digestive tract. Adv Otorhinolaryngol 39:135–144
pubmed: 2455969
Steiner W (1993) Results of curative laser microsurgery of laryngeal carcinomas. Am J Otolaryngol 14(2):116–121
doi: 10.1016/0196-0709(93)90050-H
Ambrosch P, Kron M, Steiner W (1998) Carbon dioxide laser microsurgery for early supraglottic carcinoma. Ann Otol Rhinol Laryngol 107(8):680–688. https://doi.org/10.1177/000348949810700810
doi: 10.1177/000348949810700810 pubmed: 9716871
Zeitels SM, Koufman JA, Davis RK, Vaughan CW (1994) Endoscopic treatment of supraglottic and hypopharynx cancer. Laryngoscope 104(1 Pt 1):71–78
pubmed: 8295459
Vilaseca I, Bernal-Sprekelsen M, Luis Blanch J (2010) Transoral laser microsurgery for T3 laryngeal tumors: prognostic factors. Head Neck 32(7):929–938. https://doi.org/10.1002/hed.21288
doi: 10.1002/hed.21288 pubmed: 19953612
Iro H, Waldfahrer F, Altendorf-Hofmann A, Weidenbecher M, Sauer R, Steiner W (1998) Transoral laser surgery of supraglottic cancer: follow-up of 141 patients. Archives of otolaryngology–head & neck surgery 124 (11):1245–1250
Mendenhall WM, Parsons JT, Mancuso AA, Stringer SP, Cassisi NJ (1996) Radiotherapy for squamous cell carcinoma of the supraglottic larynx: an alternative to surgery. Head Neck 18(1):24–35. https://doi.org/10.1002/(SICI)1097-0347(199601/02)18:1%3c24:AID-HED4%3e3.0.CO;2-0
doi: 10.1002/(SICI)1097-0347(199601/02)18:1%3c24::AID-HED4%3e3.0.CO;2-0 pubmed: 8774919
Spaulding CA, Krochak RJ, Hahn SS, Constable WC (1986) Radiotherapeutic management of cancer of the supraglottis. Cancer 57(7):1292–1298
doi: 10.1002/1097-0142(19860401)57:7<1292::AID-CNCR2820570707>3.0.CO;2-Z
Roh JL, Kim DH, Park CI (2008) Voice, swallowing and quality of life in patients after transoral laser surgery for supraglottic carcinoma. J Surg Oncol 98(3):184–189. https://doi.org/10.1002/jso.21101
doi: 10.1002/jso.21101 pubmed: 18561157
Canis M, Martin A, Ihler F, Wolff HA, Kron M, Matthias C, Steiner W (2013) Results of transoral laser microsurgery for supraglottic carcinoma in 277 patients. Eur Arch Oto-Rhino-Laryngol 270(8):2315–2326. https://doi.org/10.1007/s00405-012-2327-6
doi: 10.1007/s00405-012-2327-6
Harris AT, Tanyi A, Hart RD, Trites J, Rigby MH, Lancaster J, Nicolaides A, Taylor SM (2018) Transoral laser surgery for laryngeal carcinoma: has Steiner achieved a genuine paradigm shift in oncological surgery? Ann R Coll Surg Engl 100(1):2–5. https://doi.org/10.1308/rcsann.2017.0190
doi: 10.1308/rcsann.2017.0190 pubmed: 29046085
Weinstein GS, O'Malley BW Jr, Snyder W, Hockstein NG (2007) Transoral robotic surgery: supraglottic partial laryngectomy. Ann Otol Rhinol Laryngol 116(1):19–23. https://doi.org/10.1177/000348940711600104
doi: 10.1177/000348940711600104 pubmed: 17305273
Park YM, Byeon HK, Chung HP, Choi EC, Kim SH (2013) Comparison of treatment outcomes after transoral robotic surgery and supraglottic partial laryngectomy: our experience with seventeen and seventeen patients respectively. Clin Otolaryngol 38(3):270–274. https://doi.org/10.1111/coa.12101
doi: 10.1111/coa.12101 pubmed: 23441587
Park YM, Kim WS, Byeon HK, Lee SY, Kim SH (2013) Surgical techniques and treatment outcomes of transoral robotic supraglottic partial laryngectomy. Laryngoscope 123(3):670–677. https://doi.org/10.1002/lary.23767
doi: 10.1002/lary.23767 pubmed: 23288629
Lang S, Mattheis S, Hasskamp P, Lawson G, Guldner C, Mandapathil M, Schuler P, Hoffmann T, Scheithauer M, Remacle M (2017) A european multicenter study evaluating the Flex robotic system in transoral robotic surgery. Laryngoscope 127(2):391–395. https://doi.org/10.1002/lary.26358
doi: 10.1002/lary.26358 pubmed: 27783427
Mattheis S, Hasskamp P, Holtmann L, Schafer C, Geisthoff U, Dominas N, Lang S (2017) Flex robotic system in transoral robotic surgery: the first 40 patients. Head Neck 39(3):471–475. https://doi.org/10.1002/hed.24611
doi: 10.1002/hed.24611 pubmed: 27792258
Hasskamp P, Lang S, Holtmann L, Stuck BA, Mattheis S (2016) First use of a new retractor in transoral robotic surgery (TORS). Eur Arch Oto-Rhino-Laryngol 273(7):1913–1917. https://doi.org/10.1007/s00405-015-3719-1
doi: 10.1007/s00405-015-3719-1
Ambrosch P, Gonzalez-Donate M, Fazel A, Schmalz C, Hedderich J (2018) Transoral laser microsurgery for supraglottic cancer. Front Oncol 8:158. https://doi.org/10.3389/fonc.2018.00158
doi: 10.3389/fonc.2018.00158 pubmed: 29868479 pmcid: 5954241
Alon EE, Kasperbauer JL, Olsen KD, Moore EJ (2012) Feasibility of transoral robotic-assisted supraglottic laryngectomy. Head Neck 34(2):225–229. https://doi.org/10.1002/hed.21719
doi: 10.1002/hed.21719 pubmed: 21500308
Lallemant B, Chambon G, Garrel R, Kacha S, Rupp D, Galy-Bernadoy C, Chapuis H, Lallemant JG, Pham HT (2013) Transoral robotic surgery for the treatment of T1–T2 carcinoma of the larynx: preliminary study. Laryngoscope 123(10):2485–2490. https://doi.org/10.1002/lary.23994
doi: 10.1002/lary.23994 pubmed: 23918439
Smith RV (2014) Transoral robotic surgery for larynx cancer. Otolaryngol Clin North Am 47(3):379–395. https://doi.org/10.1016/j.otc.2014.03.003
doi: 10.1016/j.otc.2014.03.003 pubmed: 24882796
Gorphe P (2018) A contemporary review of evidence for transoral robotic surgery in laryngeal cancer. Front Oncol 8:121. https://doi.org/10.3389/fonc.2018.00121
doi: 10.3389/fonc.2018.00121 pubmed: 29721446 pmcid: 5915483
Razafindranaly V, Lallemant B, Aubry K, Moriniere S, Vergez S, Mones ED, Malard O, Ceruse P (2016) Clinical outcomes with transoral robotic surgery for supraglottic squamous cell carcinoma: experience of a French evaluation cooperative subgroup of GETTEC. Head Neck 38(Suppl 1):E1097–1101. https://doi.org/10.1002/hed.24163
doi: 10.1002/hed.24163 pubmed: 26435046
Schmutz A, Dieterich R, Kalbhenn J, Voss P, Loop T, Heinrich S (2018) Protocol based evaluation for feasibility of extubation compared to clinical scoring systems after major oral cancer surgery safely reduces the need for tracheostomy: a retrospective cohort study. BMC Anesthesiol 18(1):43. https://doi.org/10.1186/s12871-018-0506-8
doi: 10.1186/s12871-018-0506-8 pubmed: 29678147 pmcid: 5910593
Fattahi T, Vega L, Fernandes R, Goldman N, Steinberg B, Schare H (2012) Our experience with 171 open tracheostomies. J Oral Maxillofac Surg 70(7):1699–1702. https://doi.org/10.1016/j.joms.2011.07.015
doi: 10.1016/j.joms.2011.07.015 pubmed: 22018448
Mattheis S, Mandapathil M, Rothmeier N, Lang S, Dominas N, Hoffmann TK (2012) Transoral robotic surgery for head and neck tumors: a series of 17 patients. Laryngo Rhino Otol 91(12):768–773. https://doi.org/10.1055/s-0032-1327663
doi: 10.1055/s-0032-1327663
Park YM, Kim WS, Byeon HK, De Virgilio A, Jung JS, Kim SH (2010) Feasiblity of transoral robotic hypopharyngectomy for early-stage hypopharyngeal carcinoma. Oral Oncol 46(8):597–602. https://doi.org/10.1016/j.oraloncology.2010.05.003
doi: 10.1016/j.oraloncology.2010.05.003 pubmed: 20619721
Olsen SM, Moore EJ, Koch CA, Price DL, Kasperbauer JL, Olsen KD (2012) Transoral robotic surgery for supraglottic squamous cell carcinoma. Am J Otolaryngol 33(4):379–384. https://doi.org/10.1016/j.amjoto.2011.10.007
doi: 10.1016/j.amjoto.2011.10.007 pubmed: 22133967

Auteurs

Timon Hussain (T)

Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany.

Stephan Lang (S)

Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany. stephan.lang@uk-essen.de.

Pia Haßkamp (P)

Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany.

Laura Holtmann (L)

Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany.

Benedikt Höing (B)

Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany.

Stefan Mattheis (S)

Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH