Oncologic, functional and surgical outcomes of primary Transoral Robotic Surgery for early squamous cell cancer of the oropharynx: A systematic review

Kelly, Kate; Johnson‐Obaseki, Stephanie; Lumingu, Julie; Corsten, Martin

doi:10.1016/j.oraloncology.2014.04.005

Cited by 120 publications

(93 citation statements)

References 22 publications

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“…Increasing the intensity of therapy with some combination of surgery, chemotherapy and/or radiation therapy has been shown to increase treatment-induced toxicity [31] as well as cost [32]. Published rates of gastrostomy tube placement, for example, range from 5% [33] to as high as 85% [34], depending on the patient population and the therapeutic modalities used.…”

Section: Rationale For Treatment De-intensificationmentioning

confidence: 99%

Treatment de-intensification strategies for head and neck cancer

Kelly

Husain

Burtness

2016

European Journal of Cancer

101

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Increasingly, squamous cell carcinoma of the oropharynx (OPSCC) is attributable to transformation resulting from high-risk human papillomavirus (HPV) infection. Such cancers are significantly more responsive to treatment than traditional tobacco- and alcohol-associated squamous cell cancers of the head and neck. Conventional management with definitive chemoradiation, surgery and adjuvant radiation, or radiation given with altered fractionation schemes, while effective, incurs long-term morbidity that escalates with treatment intensity and significantly impairs quality of life. Recent trials have suggested that less intensive treatment regimens may achieve similar efficacy with decreased toxicity. In this article, we review the primary strategies used for de-escalation of treatment, which include the reduction of radiation dose, substitution and/or elimination of concurrent radiosensitising chemotherapy, and the use of minimally invasive surgery. We discuss the rationale behind these approaches and the preliminary data demonstrating the success of de-escalation, as well as potential considerations raised by treatment de-intensification in HPV-associated OPSCC.

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Section: Rationale For Treatment De-intensificationmentioning

confidence: 99%

Treatment de-intensification strategies for head and neck cancer

Kelly

Husain

Burtness

2016

European Journal of Cancer

101

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“…Tumours are primarily located around the tongue, floor of the mouth, gingiva and buccal mucosa (Kelly et al, 2014;Cabral et al, 2011). Although clinical diagnosis of late stage, invasive oral cancer is relatively straightforward, the clinical challenge remains to detect early cancerous lesions, which are significantly harder to identify.…”

Section: Introductionmentioning

confidence: 99%

Raman Micro-Spectroscopy for Rapid Screening of Oral Squamous Cell Carcinoma

Carvalho¹,

Bonnier²,

O’Callaghan

et al. 2015

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

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“…62 A second study of 190 patients revealed a 97.1% negative margin rate and a 90% disease-free survival rate, with a 95% overall survival rate. 63 De Almeida et al 15 found that TORS and IMRT both have similar overall survival rates (82%-94% for TORS versus 84%-96% for IMRT) and the only differences were in types and rates of adverse events, with the only significant common adverse event being PEG tube use. 15 Finally, TORS may offer the short-term benefit of improved oral intake and a higher likelihood of returning to baseline diet compared with CRT.…”

mentioning

confidence: 99%

Transoral Robotic Surgery in Oropharyngeal Carcinoma

Helman¹,

Schwedhelm²,

Kadakia³

et al. 2015

Archives of Pathology &Amp; Laboratory Medicine

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Context The incidence of oropharyngeal squamous cell carcinoma has increased during the past decade and is related primarily to the human papillomavirus. This change in etiology, from tobacco and alcohol to human papillomavirus, has resulted in improved survival for the disease. In the United States, open resection had largely been replaced by concurrent chemotherapy and/or radiotherapy by the early 2000s. The advent of transoral surgery has led to an increase in surgery as the primary treatment for both early- and advanced-stage oropharyngeal squamous cell carcinoma because it has potential advantages over open surgery and nonsurgical modalities. Objective To provide an overview of transoral robotic surgery for oropharyngeal squamous cell carcinoma and contrast it with other surgical and nonsurgical modalities. Data Sources Articles from 2000 to 2014 were accessioned on PubMed and reviewed for utility by the primary authors. Conclusions Transoral surgery has become more commonly used as a minimally invasive approach to treat oropharyngeal tumors. Other strategies, including radiation, chemotherapy with radiation, and open surgery, are still important treatment approaches. The treatment options for an individual patient rely on multiple factors, including the tumor location and size, features of the tumor, and patient comorbidities. The continued study of these techniques is important to match the patient with the most appropriate treatment.

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Oncologic, functional and surgical outcomes of primary Transoral Robotic Surgery for early squamous cell cancer of the oropharynx: A systematic review

Cited by 120 publications

References 22 publications

Treatment de-intensification strategies for head and neck cancer

Treatment de-intensification strategies for head and neck cancer

Raman Micro-Spectroscopy for Rapid Screening of Oral Squamous Cell Carcinoma

Transoral Robotic Surgery in Oropharyngeal Carcinoma

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