Oncological and functional outcomes for transoral robotic surgery following previous radiation treatment for upper aerodigestive tract head and neck cancers. A French multicenter GETTEC group study.
head and neck cancer
radiotherapy
squamous cell carcinoma
transoral robotic surgery
Journal
Cancer medicine
ISSN: 2045-7634
Titre abrégé: Cancer Med
Pays: United States
ID NLM: 101595310
Informations de publication
Date de publication:
Apr 2024
Apr 2024
Historique:
revised:
11
01
2024
received:
31
08
2023
accepted:
09
02
2024
medline:
28
3
2024
pubmed:
28
3
2024
entrez:
28
3
2024
Statut:
ppublish
Résumé
Transoral robotic surgery (TORS) opens new perspectives. We evaluated the outcomes for patients having undergone TORS after previous radiotherapy. A retrospective multicenter study (n = 138) in a previously irradiated area between 2009 and 2020. Survival was assessed with the Kaplan-Meier method. Prognostic factors were evaluated using a chi-squared test, Fisher's test, or Wilcoxon's test. The median length of hospital stay was 12.5 days. Bleeding was the most frequent postoperative complication (15.2%, n = 22). Prophylactic vessel ligation did not significantly decrease bleeding. Complications were significantly lower for Tis, T1, and N0 tumors. 91.6% (n = 120) of the patients with a perioperative tracheotomy could be decannulated. Larynx was functional for 65.94% of the patients. The median length of follow-up was 26 months. The 5-year overall and relapse-free survival rates were respectively 59.9% and 43.4%. Oncological and functional results confirmed the value of TORS as a treatment in previously irradiated area.
Sections du résumé
BACKGROUND
BACKGROUND
Transoral robotic surgery (TORS) opens new perspectives. We evaluated the outcomes for patients having undergone TORS after previous radiotherapy.
METHODS
METHODS
A retrospective multicenter study (n = 138) in a previously irradiated area between 2009 and 2020. Survival was assessed with the Kaplan-Meier method. Prognostic factors were evaluated using a chi-squared test, Fisher's test, or Wilcoxon's test.
RESULTS
RESULTS
The median length of hospital stay was 12.5 days. Bleeding was the most frequent postoperative complication (15.2%, n = 22). Prophylactic vessel ligation did not significantly decrease bleeding. Complications were significantly lower for Tis, T1, and N0 tumors. 91.6% (n = 120) of the patients with a perioperative tracheotomy could be decannulated. Larynx was functional for 65.94% of the patients. The median length of follow-up was 26 months. The 5-year overall and relapse-free survival rates were respectively 59.9% and 43.4%.
CONCLUSION
CONCLUSIONS
Oncological and functional results confirmed the value of TORS as a treatment in previously irradiated area.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e7031Informations de copyright
© 2024 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
Références
Hamoir M, Schmitz S, Suarez C, et al. The current role of salvage surgery in recurrent head and neck squamous cell carcinoma. Cancers (Basel). 2018;10(8):267.
Tan HK, Giger R, Auperin A, Bourhis J, Janot F, Temam S. Salvage surgery after concomitant chemoradiation in head and neck squamous cell carcinomas—stratification for postsalvage survival. Head Neck. 2010;32(2):139‐147.
Richey LM, Shores CG, George J, et al. The effectiveness of salvage surgery after the failure of primary concomitant chemoradiation in head and neck cancer. Otolaryngol Head Neck Surg. 2007;136(1):98‐103.
Goodwin WJ Jr. Salvage surgery for patients with recurrent squamous cell carcinoma of the upper aerodigestive tract: when do the ends justify the means? Laryngoscope. 2000;110(3 Pt 2 Suppl 93):1‐18.
Hamoir M, Holvoet E, Ambroise J, Lengele B, Schmitz S. Salvage surgery in recurrent head and neck squamous cell carcinoma: oncologic outcome and predictors of disease free survival. Oral Oncol. 2017;67:1‐9.
Strojan P, Corry J, Eisbruch A, et al. Recurrent and second primary squamous cell carcinoma of the head and neck: when and how to reirradiate. Head Neck. 2015;37(1):134‐150.
Sansoni ER, Gross ND. The role of transoral robotic surgery in the management of oropharyngeal squamous cell carcinoma: a current review. Curr Oncol Rep. 2015;17(3):432.
Hamilton D, Paleri V. Role of transoral robotic surgery in current head & neck practice. Surgeon. 2017;15(3):147‐154.
Aubry K, Vergez S, de Mones E, et al. Morbidity and mortality revue of the French group of transoral robotic surgery: a multicentric study. J Robot Surg. 2016;10(1):63‐67.
Iseli TA, Kulbersh BD, Iseli CE, Carroll WR, Rosenthal EL, Magnuson JS. Functional outcomes after transoral robotic surgery for head and neck cancer. Otolaryngol Head Neck Surg. 2009;141(2):166‐171.
Kelly K, Johnson‐Obaseki S, Lumingu J, Corsten M. Oncologic, functional and surgical outcomes of primary transoral robotic surgery for early squamous cell cancer of the oropharynx: a systematic review. Oral Oncol. 2014;50(8):696‐703.
Lallemant B, Moriniere S, Ceruse P, et al. Transoral robotic surgery for squamous cell carcinomas of the posterior pharyngeal wall. Eur Arch Otorrinolaringol. 2017;274(12):4211‐4216.
Mazerolle P, Philouze P, Garrel R, et al. Oncological and functional outcomes of trans‐oral robotic surgery for pyriform sinus carcinoma: a French GETTEC group study. Oral Oncol. 2018;86:165‐170.
Razafindranaly V, Lallemant B, Aubry K, et al. Clinical outcomes with transoral robotic surgery for supraglottic squamous cell carcinoma: experience of a French evaluation cooperative subgroup of GETTEC. Head Neck. 2016;38(Suppl 1):E1097‐E1101.
Weinstein GS, O'Malley BW Jr, Magnuson JS, et al. Transoral robotic surgery: a multicenter study to assess feasibility, safety, and surgical margins. Laryngoscope. 2012;122(8):1701‐1707.
Gorphe P, Simon C. A systematic review and meta‐analysis of margins in transoral surgery for oropharyngeal carcinoma. Oral Oncol. 2019;98:69‐77.
Moore EJ, Van Abel KM, Price DL, et al. Transoral robotic surgery for oropharyngeal carcinoma: surgical margins and oncologic outcomes. Head Neck. 2018;40(4):747‐755.
Sampieri C, Costantino A, Spriano G, Peretti G, De Virgilio A, Kim SH. Role of surgical margins in transoral robotic surgery: a question yet to be answered. Oral Oncol. 2022;133:106043.
Lombard B, Ceruse P. Robotics and Digital Guidance in Ent‐H&N Surgery. Elsevier; 2017:240.
Hay A, Migliacci J, Karassawa Zanoni D, et al. Complications following transoral robotic surgery (TORS): a detailed institutional review of complications. Oral Oncol. 2017;67:160‐166.
Hardman JC, Holsinger FC, Brady GC, et al. Transoral robotic surgery for recurrent tumors of the upper aerodigestive tract (RECUT): an international cohort study. J Natl Cancer Inst. 2022;114(10):1400‐1409.
de Almeida JR, Park RC, Genden EM. Reconstruction of transoral robotic surgery defects: principles and techniques. J Reconstr Microsurg. 2012;28(7):465‐472.
Gleysteen J, Troob S, Light T, et al. The impact of prophylactic external carotid artery ligation on postoperative bleeding after transoral robotic surgery (TORS) for oropharyngeal squamous cell carcinoma. Oral Oncol. 2017;70:1‐6.
Hay A, Migliacci J, Karassawa Zanoni D, et al. Haemorrhage following transoral robotic surgery. Clin Otolaryngol. 2018;43(2):638‐644.
Turner MT, Chung J, Noorkbash S, et al. Complications following salvage transoral robotic surgery with and without reconstruction: a systematic review of the literature. Oral Oncol. 2023;145:106467.
Kubik M, Mandal R, Albergotti W, Duvvuri U, Ferris RL, Kim S. Effect of transcervical arterial ligation on the severity of postoperative hemorrhage after transoral robotic surgery. Head Neck. 2017;39(8):1510‐1515.
Park YM, Jung CM, Cha D, Kim SH. The long‐term oncological and functional outcomes of transoral robotic surgery in patients with hypopharyngeal cancer. Oral Oncol. 2017;71:138‐143.
White H, Ford S, Bush B, et al. Salvage surgery for recurrent cancers of the oropharynx: comparing TORS with standard open surgical approaches. JAMA Otolaryngol Head Neck Surg. 2013;139(8):773‐778.
Park YM, Byeon HK, Chung HP, Choi EC, Kim SH. Comparison of treatment outcomes after transoral robotic surgery and supraglottic partial laryngectomy: our experience with seventeen and seventeen patients respectively. Clin Otolaryngol. 2013;38(3):270‐274.
van Weert S, Leemans CR. Salvage surgery in head and neck cancer. Oral Dis. 2021;27(1):117‐124.
Hurtuk AM, Marcinow A, Agrawal A, Old M, Teknos TN, Ozer E. Quality‐of‐life outcomes in transoral robotic surgery. Otolaryngol Head Neck Surg. 2012;146(1):68‐73.
Hammoudi K, Pinlong E, Kim S, Bakhos D, Moriniere S. Transoral robotic surgery versus conventional surgery in treatment for squamous cell carcinoma of the upper aerodigestive tract. Head Neck. 2015;37(9):1304‐1309.
Chen MM, Roman SA, Kraus DH, Sosa JA, Judson BL. Transoral robotic surgery: a population‐level analysis. Otolaryngol Head Neck Surg. 2014;150(6):968‐975.
Costantino A, Sampieri C, Pirola F, et al. Prognostic role of surgical margins in patients undergoing transoral robotic surgery after neo‐adjuvant chemotherapy. Eur J Surg Oncol. 2023;49(7):1171‐1176.
Hinni ML, Zarka MA, Hoxworth JM. Margin mapping in transoral surgery for head and neck cancer. Laryngoscope. 2013;123(5):1190‐1198.
Hamzany Y, Brasnu D, Shpitzer T, Shvero J. Assessment of margins in transoral laser and robotic surgery. Rambam Maimonides Med J. 2014;5(2):e0016.
de Almeida JR, Li R, Magnuson JS, et al. Oncologic outcomes after transoral robotic surgery: a multi‐institutional study. JAMA Otolaryngol Head Neck Surg. 2015;141(12):1043‐1051.