Transoral non-robotic surgery for oropharyngeal squamous cell carcinoma

IF 1.8 4区 医学 Q2 OTORHINOLARYNGOLOGY American Journal of Otolaryngology Pub Date : 2024-08-30 DOI:10.1016/j.amjoto.2024.104504
Giancarlo Tirelli , Simone Zucchini , Andrea D'Alessandro , Jerry Polesel , Fabiola Giudici , Alberto Vito Marcuzzo , Paolo Boscolo-Rizzo , Nicoletta Gardenal
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Abstract

Purpose

This retrospective cohort study aims to evaluate the clinical, oncological, and functional outcomes of transoral non-robotic surgery for oropharyngeal squamous cell carcinoma (OPSCC).

Materials and methods

Data from 131 patients with surgically treated OPSCC (2010-2022) were analyzed. Patients who underwent exclusively transoral surgery were included in the study. The surgeries were performed under microscopic or endoscopic guidance and either a CO2 laser or an ultrasound/radiofrequency scalpel was used as a cutting instrument, depending on the characteristics and location of the tumor. Functional outcomes were assessed in terms of length of hospital stay, tracheostomy rate, duration of feeding tube dependency and complications. Survival outcomes were assessed in terms of overall survival (OS), disease-free survival (DFS) and disease-specific survival (DSS).

Results

Of 74 included patients, transoral surgery demonstrated safety with no major complications. Tracheotomy was performed in 51.4 % of cases, and was maintained for a median of 10 days. Complete swallowing recovery was restored in 97.3 % of cases, after a median of 5 days. The median length of hospital stay was 12 days. At 5 years, OS was 68.2 %, PFS was 58.2 % and DSS was 83.6 %.

Conclusion

The study confirms the safety and efficacy of a transoral approach for OPSCC. Having the capability to utilize and access a variety of tools provides the opportunity to tailor the technique to the individual patient and specific circumstances.

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经口非机器人手术治疗口咽鳞癌
目的 这项回顾性队列研究旨在评估经口非机器人手术治疗口咽鳞状细胞癌(OPSCC)的临床、肿瘤学和功能性结果。材料和方法 分析了 131 名接受手术治疗的口咽鳞状细胞癌患者的数据(2010-2022 年)。研究对象包括完全接受经口手术的患者。手术在显微镜或内窥镜引导下进行,根据肿瘤的特征和位置,使用二氧化碳激光或超声/射频手术刀作为切割工具。对功能结果的评估包括住院时间、气管切开率、喂食管依赖时间和并发症。对生存结果的评估包括总生存率(OS)、无病生存率(DFS)和疾病特异性生存率(DSS)。51.4%的病例进行了气管切开术,中位维持时间为 10 天。97.3%的病例在中位 5 天后完全恢复了吞咽功能。住院时间中位数为 12 天。5年后,OS为68.2%,PFS为58.2%,DSS为83.6%。该研究证实了经口方法治疗 OPSCC 的安全性和有效性。利用和获取各种工具的能力使我们有机会根据患者的个体情况和具体情况来调整技术。
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来源期刊
American Journal of Otolaryngology
American Journal of Otolaryngology 医学-耳鼻喉科学
CiteScore
4.40
自引率
4.00%
发文量
378
审稿时长
41 days
期刊介绍: Be fully informed about developments in otology, neurotology, audiology, rhinology, allergy, laryngology, speech science, bronchoesophagology, facial plastic surgery, and head and neck surgery. Featured sections include original contributions, grand rounds, current reviews, case reports and socioeconomics.
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