Transoral robotic surgery for oropharyngeal carcinoma: Surgical margins and oncologic outcomes

Transoral robotic surgery for oropharyngeal carcinoma: Surgical margins and oncologic outcomes INTRODUCTIONTreatment for oropharyngeal squamous cell carcinoma (SCC) consists of complete surgical resection, radiotherapy (RT), RT and chemotherapy (CRT), or combinations thereof. In the past decade, providers have recognized that human papillomavirus (HPV)‐mediated oropharyngeal SCC often responds exceedingly well to treatment regardless of modality; yet, the treatment choice itself may result in long‐term morbidity. This has generated interest in “deintensification” strategies that seek to maintain oncologic outcomes while minimizing treatment‐related morbidity.Since 2007, our institution has used transoral robotic surgery (TORS) ± adjuvant RT or CRT based on pathologic staging for patients with surgically resectable oropharyngeal SCC. The TORS‐based therapy is used with the goal of complete surgical resection with clear microscopic margins. We have presented preliminary studies with this technique, but this article represents long‐term experience using TORS‐based therapy with frozen section margin clearance for oropharyngeal SCC in what we believe to be the largest single institutional review presented to date. Herein, we specifically investigate the oncologic outcomes experienced by patients treated with: (1) TORS alone; (2) TORS + RT (surgery [S]‐RT); and (3) TORS + CRT (S‐CRT) and analyze factors that may influence these outcomes.MATERIALS AND METHODSPatient selectionAfter institutional review board approval (14‐004693) all patients who underwent TORS for http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Head & Neck: Journal for the Sciences & Specialties of the Head and Neck Wiley

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Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
© 2018 Wiley Periodicals, Inc.
ISSN
1043-3074
eISSN
1097-0347
D.O.I.
10.1002/hed.25055
Publisher site
See Article on Publisher Site

Abstract

INTRODUCTIONTreatment for oropharyngeal squamous cell carcinoma (SCC) consists of complete surgical resection, radiotherapy (RT), RT and chemotherapy (CRT), or combinations thereof. In the past decade, providers have recognized that human papillomavirus (HPV)‐mediated oropharyngeal SCC often responds exceedingly well to treatment regardless of modality; yet, the treatment choice itself may result in long‐term morbidity. This has generated interest in “deintensification” strategies that seek to maintain oncologic outcomes while minimizing treatment‐related morbidity.Since 2007, our institution has used transoral robotic surgery (TORS) ± adjuvant RT or CRT based on pathologic staging for patients with surgically resectable oropharyngeal SCC. The TORS‐based therapy is used with the goal of complete surgical resection with clear microscopic margins. We have presented preliminary studies with this technique, but this article represents long‐term experience using TORS‐based therapy with frozen section margin clearance for oropharyngeal SCC in what we believe to be the largest single institutional review presented to date. Herein, we specifically investigate the oncologic outcomes experienced by patients treated with: (1) TORS alone; (2) TORS + RT (surgery [S]‐RT); and (3) TORS + CRT (S‐CRT) and analyze factors that may influence these outcomes.MATERIALS AND METHODSPatient selectionAfter institutional review board approval (14‐004693) all patients who underwent TORS for

Journal

Head & Neck: Journal for the Sciences & Specialties of the Head and NeckWiley

Published: Jan 1, 2018

Keywords: ; ; ; ;

References

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