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人乳头瘤病毒时代的经口机器人手术

Transoral Robotic Surgery in the HPV Era.

作者信息

Duek Irit, Billan Salem, Amit Moran, Gil Ziv

机构信息

Department of Otolaryngology Head and Neck Surgery, Rambam Health Care Campus, Haifa, Israel;

The Oncology Institute, Rambam Health Care Campus, Haifa, Israel;

出版信息

Rambam Maimonides Med J. 2014 Apr 28;5(2):e0010. doi: 10.5041/RMMJ.10144. eCollection 2014 Apr.

Abstract

The incidence of oropharyngeal squamous cell carcinoma (OPSCC) has markedly increased over the last three decades mostly due to human papillomavirus (HPV)-related infections. Cancers resulting from HPV infection bear a better prognosis than those that are smoking-related. Because HPV-positive patients are often younger, with lower rates of co-morbid illness and longer overall life expectancies, long-term sequelae of therapy have become an important issue. Treatment of oropharyngeal cancers has typically involved the use of radiation and chemotherapy to avoid the morbidity of open surgery which included mandibulotomy and composite resection. Transoral robotic surgery (TORS) is an emerging treatment option for this disease, avoiding the morbidity of open approaches while providing excellent oncologic and functional outcomes. With overall survival rate at 2 years exceeding 80%, and local failure rate of less than 3%, patients receiving TORS report relatively good health-related quality of life (QOL) scores. The aim of the current review is to provide a summary of the current literature with regard to the oncologic and functional outcomes following treatment of OPSCC with TORS.

摘要

在过去三十年中,口咽鳞状细胞癌(OPSCC)的发病率显著上升,这主要归因于人类乳头瘤病毒(HPV)相关感染。由HPV感染引发的癌症比那些与吸烟相关的癌症预后更好。由于HPV阳性患者通常较为年轻,合并疾病发生率较低且总体预期寿命更长,治疗的长期后遗症已成为一个重要问题。口咽癌的治疗通常涉及使用放疗和化疗,以避免包括下颌骨切开术和复合切除术在内的开放性手术的发病率。经口机器人手术(TORS)是治疗这种疾病的一种新兴选择,它既能避免开放性手术的发病率,又能提供出色的肿瘤学和功能结果。两年总生存率超过80%,局部失败率低于3%,接受TORS治疗的患者报告的健康相关生活质量(QOL)评分相对较好。本综述的目的是总结当前关于TORS治疗OPSCC后的肿瘤学和功能结果的文献。

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