Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center Pittsburgh, Pennsylvania.
medical student, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
JAMA Otolaryngol Head Neck Surg. 2015 Jun;141(6):499-504. doi: 10.1001/jamaoto.2015.0347.
Few studies have examined quality-of-life (QOL) outcomes in patients who undergo transoral robotic surgery (TORS) alone (ie, without adjuvant radiotherapy or chemoradiotherapy).
To report QOL outcomes of patients with oropharyngeal squamous cell carcinoma who receive only TORS.
DESIGN, SETTING, AND PARTICIPANTS: Medical records for all patients undergoing TORS for treatment of primary oropharyngeal squamous cell carcinoma from May 1, 2010, to March 31, 2014, at a tertiary care academic cancer center were examined from June through September 2014. Thirty-four patients who did not receive adjuvant therapy after TORS were included in the study.
Primary surgical resection via TORS.
The University of Washington Quality of Life, version 4, questionnaire was completed by patients preoperatively and at 1-, 6-, 12-, and 24-month intervals after TORS. Demographic, clinicopathologic, and follow-up data were collected.
Mean follow-up time was 14 months (May 1, 2010, to April 30, 2014). Most patients had T1 (20 [59%]) or T2 (13 [38%]) and N0 (13 [38%]) or N1 (16 [47%]) disease. Statistically significant improvement in QOL outcomes was noted in the following postoperative domains: chewing from 1 month (median, 50 [IQR, 50-100]) to 12 months (100 [IQR, 100-100]; P = .048), swallowing from 1 month (70 [IQR, 30-85]) to 6 months (100 [IQR, 70-100]; P = .047) and 1 to 24 months (100 [IQR, 70-100]; P = .048), pain from 1 month (38 [IQR, 25-75]) to 6 months (88 [IQR, 75-100]; P = .006) and 1 to 12 months after surgery (100 [IQR, 75-100]; P = .01), and activity from 1 month (63 [IQR, 50-88]) to 24 months (100 [IQR, 75-100]; P = .03). Two participants (6%) died during the follow-up period: 1 because of disease and 1 because of a myocardial infarction. Two patients (6%) required temporary gastrostomy tube placement, but none required tracheostomy.
Appropriately selected patients who undergo TORS alone for oropharyngeal squamous cell carcinoma experience acceptable short- and long-term QOL outcomes.
很少有研究检查单独接受经口机器人手术（TORS）（即无辅助放疗或放化疗）的患者的生活质量（QOL）结果。
报告仅接受 TORS 治疗的口咽鳞状细胞癌患者的 QOL 结果。
设计、地点和参与者：2010 年 5 月 1 日至 2014 年 3 月 31 日期间，在一家三级癌症治疗学术中心接受 TORS 治疗原发性口咽鳞状细胞癌的所有患者的病历于 2014 年 6 月至 9 月进行了检查。在 TORS 后未接受辅助治疗的 34 名患者被纳入研究。
通过 TORS 进行主要的手术切除。
患者在术前以及 TORS 后 1、6、12 和 24 个月时使用华盛顿大学生活质量问卷第 4 版进行评估。收集人口统计学、临床病理学和随访数据。
平均随访时间为 14 个月（2010 年 5 月 1 日至 2014 年 4 月 30 日）。大多数患者患有 T1（20 例[59%]）或 T2（13 例[38%]）和 N0（13 例[38%]）或 N1（16 例[47%]）疾病。在以下术后领域观察到 QOL 结果的显著改善：咀嚼功能从 1 个月（中位数，50 [IQR，50-100]）到 12 个月（100 [IQR，100-100]；P=.048），吞咽功能从 1 个月（70 [IQR，30-85]）到 6 个月（100 [IQR，70-100]；P=.047）和 1 至 24 个月（100 [IQR，70-100]；P=.048），疼痛从 1 个月（38 [IQR，25-75]）到 6 个月（88 [IQR，75-100]；P=.006）和 1 至 12 个月（100 [IQR，75-100]；P=.01），以及活动能力从 1 个月（63 [IQR，50-88]）到 24 个月（100 [IQR，75-100]；P=.03）。在随访期间，有 2 名患者（6%）死亡：1 例因疾病，1 例因心肌梗死。有 2 名患者（6%）需要临时胃造口管放置，但均无需气管造口术。
接受单独 TORS 治疗的口咽鳞状细胞癌的适当选择患者，其短期和长期生活质量结果是可以接受的。
