Decision management in transoral robotic surgery: Indications, individual patient selection, and role in the multidisciplinary treatment for head and neck cancer from a European perspective

Lőrincz, Balázs B.; Jowett, Nate; Knecht, Rainald

doi:10.1002/hed.24059

Cited by 50 publications

(44 citation statements)

References 36 publications

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“…Only 1.0% of TORS patients compared to 5.1% of open surgery patients had fistula formation [3]. These are in line with other non-comparative studies which reported that TORS shortens the time to resumption of ambulation and speech functions and are related to lower rates of postoperative complications such as infections and fistula formation [6], [7], [8], [9]. Despite these known advantages, we report a case here to illustrate the possibility of invasive candidiasis in a patient who has undergone TORS.…”

Section: Introductionsupporting

confidence: 79%

A case report of invasive candidiasis and fungal osteomyelitis mimicking oropharyngeal carcinoma recurrence in an immunocompetent patient following transoral robotic surgery

Tan

Low

Roche³

et al. 2017

International Journal of Surgery Case Reports

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Section: Introductionsupporting

confidence: 79%

A case report of invasive candidiasis and fungal osteomyelitis mimicking oropharyngeal carcinoma recurrence in an immunocompetent patient following transoral robotic surgery

Tan

Low

Roche³

et al. 2017

International Journal of Surgery Case Reports

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“…The use of less toxic treatment options is often recommended in the management of HPV p16-positive OPSCC because the patients are younger and display a better 5-year survival rate than patients with HPV-negative OPSCC 1314…”

Section: Discussionmentioning

confidence: 99%

Incidental finding of an extensive oropharyngeal mass in magnetic resonance imaging of a patient with temporomandibular disorder: A case report

2016

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In this report, we describe the incidental finding of an oropharyngeal mass in a patient who presented with a chief complaint of temporomandibular pain. The patient was initially evaluated by an otorhinolaryngologist for complaints of headaches, earache, and sinus congestion. Due to worsening headaches and trismus, he was further referred for the management of temporomandibular disorder. The clinical evaluation was uneventful except for limited mouth opening (trismus). An advanced radiological evaluation using magnetic resonance imaging revealed a mass in the nasopharyngeal/oropharyngeal region. The mass occupied the masticatory space and extended superioinferiorly from the skull base to the mandible. A diagnostic biopsy of the lesion revealed a long-standing human papilloma virus (HPV-16)-positive squamous cell carcinoma of the oropharynx. This case illustrates the need for the timely radiological evaluation of seemingly innocuous orofacial pain.

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“…In the late 1990s, organ preservation trials demonstrated survival benefits of chemoradiotherapy (CRT) over radiotherapy (RT) alone, 9 leading to increased use of CRT in the early 2000s. 10, 11 However, there has recently been renewed enthusiasm for primary surgical approaches for the treatment of OPSCC 12–14 . This has been driven by technologic advances such as transoral robotic surgery (TORS) that enhance the feasibility of surgery for low T classification OPSCC and offer the potential of avoiding or de-escalating adjuvant treatments.…”

Section: Introductionmentioning

confidence: 99%

Increase in primary surgical treatment of T1 and T2 oropharyngeal squamous cell carcinoma and rates of adverse pathologic features: National Cancer Data Base

Cracchiolo

Baxi

Morris

et al. 2016

Cancer

140

144

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Background There has been increasing interest in primary surgical treatment of patients with early T classification (T1–T2) oropharyngeal squamous cell carcinoma (OPSCC), with the stated goal of de-escalating or avoiding adjuvant treatment. We sought to determine the degree to which this interest has translated into changes in practice patterns, and the rates of adverse post-operative pathologic features. Methods Patients with T1–T2 OPSCC in the National Cancer Database (NCDB) treated from 2004–2013 were categorized as receiving primary surgical or primary radiation-based treatment. Trends in treatment selection and factors related to selection of primary surgery were examined. The rates of adverse pathologic features including positive margins, extracapsular spread (ECS), and advanced T and N stage following surgery were analyzed. Results Of 8,768 patients with T1–T2 OPSCC, 68% received primary surgical treatment, increasing from 56% in 2004 to 82% in 2013 (p<0.0001). The highest versus lowest volume hospitals treated 78% versus 59% of patients with primary surgery (O.R. 2.23 C.I. 1.55–3.22, p<0.0001). Higher nodal stage predicted lower rates of primary surgery, but the majority of patients with clinical N2/N3 disease underwent primary surgery. Among surgical patients, positive margins were present in 24% and ECS in 25%. Positive margins decreased over time (p<0.0001) and were seen less often at high volume centers (p<0.0001). Among candidates for single modality therapy (clinical T1–T2/N0–N1), 33% had positive margins and/or ECS, and 47% had at least one adverse feature (T3–T4, N2–N3, positive margins, and/or ECS). Conclusion Primary surgical treatment for early T-stage OPSCC has become more widespread.

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Decision management in transoral robotic surgery: Indications, individual patient selection, and role in the multidisciplinary treatment for head and neck cancer from a European perspective

Abstract: A consensus regarding the indications of TORS and its role in the multidisciplinary management of HNSCC is to be established. © 2015 Wiley Periodicals, Inc. Head Neck 38: E2190-E2196, 2016.

Cited by 50 publications

References 36 publications

A case report of invasive candidiasis and fungal osteomyelitis mimicking oropharyngeal carcinoma recurrence in an immunocompetent patient following transoral robotic surgery

A case report of invasive candidiasis and fungal osteomyelitis mimicking oropharyngeal carcinoma recurrence in an immunocompetent patient following transoral robotic surgery

Incidental finding of an extensive oropharyngeal mass in magnetic resonance imaging of a patient with temporomandibular disorder: A case report

Increase in primary surgical treatment of T1 and T2 oropharyngeal squamous cell carcinoma and rates of adverse pathologic features: National Cancer Data Base

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