Durmus Kasim, Rangarajan Sanjeet V, Old Matthew O, Agrawal Amit, Teknos Theodoros N, Ozer Enver
Department of Otolaryngology - Head and Neck Surgery, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Comprehensive Cancer Center, Wexner Medical Center at The Ohio State University, Columbus, Ohio.
Head Neck. 2014 Jun;36(6):848-52. doi: 10.1002/hed.23385. Epub 2013 Sep 2.
The management of carcinoma of unknown primary (CUP) is one of the challenging conditions in head and neck oncologic surgery. Despite various diagnostic tools, the primary tumor site in more than half of cases remains unidentified. The purpose of this study was to assess the feasibility and efficiency of utilizing transoral robotic surgery (TORS) for the diagnosis and treatment of CUP in the head and neck.
In this prospective, single-institutional, clinical TORS trial, 22 of 181 patients were treated for CUP between 2008 and 2012.
Among all those 22 patients, primary tumor site identification and complete tumor removal was achieved in 17 patients (77.3%) with TORS. Tonsil (59.1%) and base of tongue (18.1%) were identified as the most common tumor locations.
Together with panendoscopy, directed biopsies, and positron emission tomography (PET)/CT, TORS is a valuable option in the identification and treatment of primary tumor sites.
原发灶不明癌（CUP）的治疗是头颈肿瘤外科中具有挑战性的情况之一。尽管有各种诊断工具，但超过半数病例的原发肿瘤部位仍无法确定。本研究的目的是评估利用经口机器人手术（TORS）对头颈部位CUP进行诊断和治疗的可行性及有效性。
在这项前瞻性、单机构临床TORS试验中，2008年至2012年间，181例患者中有22例接受了CUP治疗。
在这22例患者中，17例（77.3%）通过TORS实现了原发肿瘤部位的识别及肿瘤的完整切除。扁桃体（59.1%）和舌根（18.1%）被确定为最常见的肿瘤部位。
与全景内镜检查、定向活检及正电子发射断层扫描（PET）/CT一起，TORS是识别和治疗原发肿瘤部位的一种有价值的选择。
