Transoral robotic surgery for oropharyngeal squamous cell carcinoma: A prospective study of feasibility and functional outcomes

Moore, Eric J.; Olsen, Kerry D.; Kasperbauer, Jan L.

doi:10.1002/lary.20647

Cited by 332 publications

(409 citation statements)

References 17 publications

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“…The oncologic contraindications are fixation of the tumor, direct extension to the cervical lymph nodes, extension of tumor to the lateral pharyngeal wall, distant metastasis/ unresectable nodal disease/skin metastasis, or involvement of [50 % of the BOT or to such an extent that major flap reconstruction would be necessary to close defect (relative contraindication). The anatomic contraindications include severe trismus, pharyngeal/tongue crowding preventing adequate tumor exposure, and the presence of a retropharyngeal carotid artery [30,31]. Physiologic contraindications are related to patient comorbidities that would prevent general anesthesia or decrease the ability to heal by secondary intention.…”

Section: Managementmentioning

confidence: 99%

Surgical Management of Oropharyngeal Squamous Cell Carcinoma

Abel

Moore

2013

Curr Otorhinolaryngol Rep

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Squamous cell carcinoma of the oropharynx (OPSCC) occurs with an age-adjusted incidence rate of 2.2/ 100,000 per year, and makes up one of the largest growing subsets of head and neck cancer. Traditional risk factors include alcohol and tobacco exposure, however, the demographics have changed significantly over the past 2-3 decades, with human papillomavirus (HPV) infection now considered one of the most important risk factors. As our understanding of HPV-related OPSCC has developed, there has been increasing evidence that this new tumor subtype has a better overall prognosis and response to therapies. This review focuses on OPSCC from a surgical perspective. We review the relevant anatomy, diagnosis and workup, and discuss several different surgical approaches for management of this disease, including transoral robotic surgery, lateral oropharyngectomy and tonsillectomy, base of tongue resection, and neck dissection. In addition, the common complications associated with these treatment options are discussed.

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Section: Managementmentioning

confidence: 99%

Surgical Management of Oropharyngeal Squamous Cell Carcinoma

Abel

Moore

2013

Curr Otorhinolaryngol Rep

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“…Moore et al [23] at The Mayo Clinic reported a prospective series of 45 patients with T1-T4 squamous cell carcinoma of the base of tongue or tonsillar fossae who were all treated with TORS. They found that TORS was safe and feasible and reported that all of the 45 TORS procedures performed were resected with negative margins.…”

Section: Surgical Options For Treatment Of Opsccmentioning

confidence: 99%

“…Moore et al performed TORS on 45 patients, and 82 % of patients were tolerating an oral diet by the first post-operative visit. Seventeen percent of patients required a feeding tube, but none required assistance with feeding at 1-year follow-up [23]. Hurtuk et al [32] also described an early return to oral diet with all 54 patients in their study tolerating oral diet on the day of surgery.…”

Section: Functional Outcomes and Quality Of Lifementioning

confidence: 99%

The Role for Surgical Management of HPV-Related Oropharyngeal Carcinoma

Genden

2012

Head and Neck Pathol

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Human papillomavirus (HPV)-associated oropharyngeal carcinoma has become the predominate cause of oropharyngeal carcinoma in the United States and Europe. Management of this disease is controversial. Traditional open surgical techniques gave way to concurrent chemoradiotherapy following several American and European organ-preservation trials suggesting that both modalities were equally efficacious. More recently, minimally invasive surgical techniques have gained popularity. These techniques provide an opportunity to achieve a complete surgical resection without the treatment-related morbidity associated with open surgery. Proponents of this technique contend that transoral surgical techniques provide a means to analyze the tumor tissue, prognosticate, and personally direct therapy. Skeptics suggest that HPVassociated oropharyngeal carcinoma responds well to chemoradiotherapy and that surgery may not provide a treatment advantage. Both approaches provide a unique perspective and both are currently being studied under trial.

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“…The present study compares the adverse effects of surgical removal of histologically-proven T1 and T2 scc of tongue base and supraglottis, performed by two different techniques, namely by conventional open surgery (os) and Tors (ref. [10][11][12] ). To the best of our knowledge -such a comparison has not been made so far.…”

Section: Introductionmentioning

confidence: 99%

Short-term postoperative distress associated with open vs. transoral robotic surgery (TORS) in patients with T1-T2 carcinomas of the tongue base and supraglottis

Sláma¹,

Slouka²,

Slípka³

et al. 2016

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Background. This study compared the adverse effects of open surgery (OS) including lateral pharyngotomy and supraglottic laryngectomy vs. transoral robotic surgery (TORS) in the treatment of stage T1 and T2 carcinomas of the tongue base and supraglottis. Methods. A retrospective study involving a 49 (13 female and 36 male) patients with untreated T1 or T2 carcinomas. Twenty two were operated on using TORS and 27 underwent conventional OS. The indicators for comparison were: total blood loss during surgery, post-operative pain measured with the Visual Analog Scale (VAS); global, emotional and physical post-operational states assessed with the standardized M.D. Anderson Dysphagia Inventory (MDADI) and psychosocial distress (PD) questionnaire. Apart from blood loss, subjective symptoms were evaluated 1 and 6 weeks and 6 months after surgery. The differences in indicators between groups were analyzed using Fisher's Least Significant Difference (LSD) test at the 5% significance level. Results. Mean general OS and TORS associated blood loss were 405 and 29 ml, respectively. The mean MDADI score in TORS vs. OS patients one week, six weeks and six months postoperatively was 60.01 vs. 44.93, 91.01 vs. 62.19 and 94.18 vs. 93.56. The mean VAS score in the TORS vs. OS group at the same time intervals were 5.09 vs. 5.56, 2.09 vs. 3.11 and 1.27 vs. 1.33. All differences between TORS and OS were statistically significant with the exception of 6 month values for particular scores. The mean PD score in TORS vs. OS patients in one week, six weeks and 6 months was 26.82 vs. 25.11, 39.95 vs. 29.22 and 44.73 vs. 44.52. Only the six week distinctions were significant. The both methods were comparable in terms of the risk of locoregional tumour recurrence. Conclusions. The study confirmed the assumption of the TORS as a minimally invasive procedure significantly reducing the intraoperative blood loss, pain, swallowing and psychosocial distress as late as 6 weeks postoperatively in patients with early staged carcinomas of the tongue base and supraglottis.

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Transoral robotic surgery for oropharyngeal squamous cell carcinoma: A prospective study of feasibility and functional outcomes

Cited by 332 publications

References 17 publications

Surgical Management of Oropharyngeal Squamous Cell Carcinoma

Surgical Management of Oropharyngeal Squamous Cell Carcinoma

The Role for Surgical Management of HPV-Related Oropharyngeal Carcinoma

Short-term postoperative distress associated with open vs. transoral robotic surgery (TORS) in patients with T1-T2 carcinomas of the tongue base and supraglottis

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