The emerging role of trans-oral robotic surgery for the detection of the primary tumour site in patients with head-neck unknown primary cancers: A meta-analysis

Giuseppe Meccariello; Giovanni Cammaroto; Enyinnaya Ofo; Sebastiano Calpona; Elisabetta Parisi; Giovanni D'Agostino; Riccardo Gobbi; Elisabetta Firinu; Chiara Bellini; Andrea De Vito; Filippo Montevecchi; Matteo Costantini; Elena Amadori; Simona Nuzzo; Stefano Pelucchi; Claudio Vicini

doi:10.1016/j.anl.2019.04.007

The emerging role of trans-oral robotic surgery for the detection of the primary tumour site in patients with head-neck unknown primary cancers: A meta-analysis

Auris Nasus Larynx. 2019 Oct;46(5):663-671. doi: 10.1016/j.anl.2019.04.007. Epub 2019 May 4.

Authors

Giuseppe Meccariello¹, Giovanni Cammaroto², Enyinnaya Ofo³, Sebastiano Calpona⁴, Elisabetta Parisi⁵, Giovanni D'Agostino⁶, Riccardo Gobbi⁶, Elisabetta Firinu⁶, Chiara Bellini⁶, Andrea De Vito⁶, Filippo Montevecchi⁶, Matteo Costantini⁷, Elena Amadori⁸, Simona Nuzzo⁹, Stefano Pelucchi¹⁰, Claudio Vicini⁶

Affiliations

¹ Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Azienda USL della Romagna, Forlì, Italy. Electronic address: drmeccariello@gmail.com.
² Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Azienda USL della Romagna, Forlì, Italy; Department of Otolaryngology and Head-Neck Surgery, University of Messina, Italy.
³ St George's University Hospital, Kingston Hospital NHS Foundation Trusts, London, UK.
⁴ Osteoncology and Rare Tumors Center, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori(IRST), IRCCS, Meldola, Italy.
⁵ Radiotherapy Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori(IRST), IRCCS, Meldola, Italy.
⁶ Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Azienda USL della Romagna, Forlì, Italy.
⁷ Department of Surgical Pathology, Morgagni Pierantoni Hospital, Azienda USL della Romagna, Forlì, Italy.
⁸ Radiology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori(IRST), IRCCS, Meldola, Italy.
⁹ Department of Biostatistics, Azienda USL della Romagna, Forlì, Italy.
¹⁰ ENT Department, University Hospital of Ferrara, Italy.

PMID: 31064689
DOI: 10.1016/j.anl.2019.04.007

Abstract

The identification of the site in head neck unknown primary (HNUP) tumour is of utmost importance to help select best treatment while decreasing treatment-related morbidity and mortality. The primary purpose of this study is to demonstrate that TORS may be a valuable tool in detecting primary tumour. Studies were systematically searched in the PubMed, EMBASE, the Cochrane Library and CENTRAL electronic databases. A total of 12 selected studies (349 patients) were analyzed. The primary tumour detection and positive surgical margins rates were 70.8% and 19.4%, respectively. The rate of HPV-related tumour was 71.3%. The primary tumour was mainly in base of tongue (64%). In conclusion, TORS seems to be an effective surgical approach both in terms of detection of primary tumour site and in terms of therapeutic perspective for HNUP. In particular, a subset of HPV-related tumours might benefits all advantages from this surgical modality.

Keywords: Head neck; Lymph nodes; Robotic; Surgical procedures; Unknown primary tumors.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Head and Neck Neoplasms / diagnosis*
Head and Neck Neoplasms / secondary
Head and Neck Neoplasms / surgery
Humans
Lymph Nodes / pathology*
Neck
Neoplasms, Unknown Primary / diagnosis*
Neoplasms, Unknown Primary / surgery
Oropharyngeal Neoplasms / diagnosis
Oropharyngeal Neoplasms / pathology
Oropharyngeal Neoplasms / surgery
Papillomavirus Infections / diagnosis*
Robotic Surgical Procedures / methods*
Squamous Cell Carcinoma of Head and Neck / diagnosis*
Squamous Cell Carcinoma of Head and Neck / secondary
Squamous Cell Carcinoma of Head and Neck / surgery
Tongue Neoplasms / diagnosis
Tongue Neoplasms / pathology
Tongue Neoplasms / surgery