Trans oral robotic surgery for oropharyngeal cancer: A multi institutional experience

Armando De Virgilio; Raul Pellini; Giovanni Cammaroto; Rossella Sgarzani; Andrea De Vito; Manlio Gessaroli; Andrea Costantino; Gerardo Petruzzi; Bianca Maria Festa; Flaminia Campo; Claudio Moretti; Barbara Pichi; Giuseppe Mercante; Giuseppe Spriano; Claudio Vicini; Giuseppe Meccariello

doi:10.1016/j.ejso.2023.05.020

Trans oral robotic surgery for oropharyngeal cancer: A multi institutional experience

Eur J Surg Oncol. 2023 Sep;49(9):106945. doi: 10.1016/j.ejso.2023.05.020. Epub 2023 Jun 12.

Authors

Armando De Virgilio¹, Raul Pellini², Giovanni Cammaroto³, Rossella Sgarzani⁴, Andrea De Vito³, Manlio Gessaroli⁵, Andrea Costantino¹, Gerardo Petruzzi⁶, Bianca Maria Festa¹, Flaminia Campo⁶, Claudio Moretti⁷, Barbara Pichi⁶, Giuseppe Mercante¹, Giuseppe Spriano¹, Claudio Vicini⁸, Giuseppe Meccariello³

Affiliations

¹ Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 4, 20090, Pieve Emanuele, MI, Italy; Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, MI, Italy.
² Department of Otolaryngology-Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy. Electronic address: raul.pellini@ifo.it.
³ Otolaryngology and Head-Neck Surgery Unit, Department of Surgery, Morgagni Pierantoni Hospital, Azienda USL della Romagna, Forlì, Italy.
⁴ Plastic Surgery, DIMES Department, University of Bologna, Bologna, Italy.
⁵ Maxillo-Facial Unit, Department of Surgery, Maurizio Bufalini Hospital, Azienda USL della Romagna, Cesena, Italy.
⁶ Department of Otolaryngology-Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
⁷ Department of Otolaryngology-Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy; University of Ferrara, Ferrara, Italy.
⁸ Otolaryngology and Head-Neck Surgery Unit, Department of Surgery, Morgagni Pierantoni Hospital, Azienda USL della Romagna, Forlì, Italy; University of Ferrara, Ferrara, Italy.

PMID: 37331862
DOI: 10.1016/j.ejso.2023.05.020

Abstract

Objectives: Trans Oral Robotic Surgery (TORS) has proved to be a safe and feasible treatment for oropharyngeal squamous cell carcinoma (OPSCC). The aim of this study is to analyse oncological outcomes of OPSCC patients treated with TORS.

Materials and methods: This study involved 139 patients with OPSCC, treated with TORS between 2008 and 2020. Clinicopathological characteristics, treatment details and oncological outcomes were evaluated retrospectively.

Results: The management strategies included TORS alone in 42.5%, TORS-RT in 25.2% and TORS-CRT in 30.9%. The ENE was noted in 28.8% of neck dissections. In 19 patients clinically classified as unknown primaries, the primary was found in 73.7%. Rates of local, regional relapses and distant metastasis were 8.6%, 7.2%, and 6.5%, respectively. The 5 year- Overall Survival and Disease Free Survival were 69.6% and 71.3%, respectively.

Conclusion: TORS fits well in the modern management of OPSCC. Although definitive CRT remains a milestone, TORS is proving to be a valid and safe treatment option. The choice of the therapeutic strategy requires evaluation by a multidisciplinary team.

Keywords: Cancer; Chemotherapy; Oropharyngeal; Outcomes; Quality of life; Radiotherapy; Survival; Trans oral robotic surgery.

Publication types

Multicenter Study

MeSH terms

Head and Neck Neoplasms*
Humans
Neoplasm Recurrence, Local / etiology
Oropharyngeal Neoplasms* / pathology
Oropharyngeal Neoplasms* / surgery
Retrospective Studies
Robotic Surgical Procedures* / adverse effects
Squamous Cell Carcinoma of Head and Neck