Long-term Functional and Quality-of-Life Outcomes After Transoral Robotic Surgery in Patients With Oropharyngeal Cancer

Abstract

Patients who underwent TORS+CRT demonstrated poorer long-term outcomes, with continued dysphagia more than 1 year after surgery. These findings support the investigation of adjuvant de-escalation therapies to reduce the long-term adverse effects of treatment.

Long‐term analysis of transorally resected p16 + Oropharynx cancer: Outcomes and prognostic factors

“…The observed long‐term oncologic outcomes in our p16‐positive OPSCC cohort have remained as favorable, as in our previously reported thesis . Transoral surgery, including TLM and TORS, has been associated with better survival for OPSCC . However, long‐term outcomes specific to transorally treated p16‐positive OPSCC are lacking or come from studies with a small number of patients.…”

Long‐term swallowing outcomes following transoral surgery and adjuvant radiotherapy vs adjuvant chemoradiotherapy for oropharyngeal carcinoma: Our experience in 37 patients

“…Systematic review data of the functional outcomes after TORS highlight the current lack of robust data, mainly due to heterogeneity of the functional assessment tools used, small cohort sizes and variable length of follow‐up . Several studies however support our findings in suggesting that there is a functional advantage to de‐intensifying adjuvant treatment after TOS …”

“…Whilst there is mounting evidence that primary transoral surgery (TOS) without adjuvant treatment is functionally advantageous, adjuvant treatment is currently recommended in up to 75% of patients, due to higher nodal staging or adverse pathological features. There is evidence to suggest that there is a similar functional advantage to de‐intensifying adjuvant treatment . This study aims to analyse the long‐term swallowing function in patients treated with transoral surgery and adjuvant treatment, comparing adjuvant radiotherapy to adjuvant chemoradiotherapy.…”

Prospective instrumental evaluation of swallowing, tongue function, and QOL measures following transoral robotic surgery alone without adjuvant therapy

“…Although others have reported the need for tracheostomy and PEG tubes, no patient in our cohort required either, although admittedly the size of our cohort is limited. In addition, only half the patients needed adjuvant radiotherapy.…”

“…PSS domains of poorer speech understandability and ability to eat in public have also been observed in patients with adjuvant treatment, with the poorest functioning occurring in those with adjuvant chemoradiotherapy . Others found poorer QOL in patients undergoing adjuvant treatment as compared to TORS surgery alone, with the poorest QOL found with adjuvant chemoradiotherapy …”