Troob Scott, Givi Babak, Hodgson Macgregor, Mowery Alia, Gross Neil D, Andersen Peter E, Clayburgh Daniel
Department of Otolaryngology - Head and Neck Surgery, New York Presbyterian / Columbia University Medical Center, New York, New York.
Department of Otolaryngology - Head and Surgery, New York University, New York, New York.
Head Neck. 2017 Oct;39(10):1969-1975. doi: 10.1002/hed.24786. Epub 2017 Jul 31.
Assessment of the retropharyngeal lymph nodes is essential in the treatment for oropharyngeal squamous cell carcinoma (SCC). Transoral robotic retropharyngeal lymph node dissection (RPLND) may provide valuable staging information and guide selection of adjuvant therapy in a transoral robotic surgery (TORS) treatment paradigm.
Outcomes were compared between 30 patients with oropharyngeal SCC with tonsillar primaries undergoing RPLND and 37 stage-matched cases without RPLND.
Retropharyngeal metastasis was confirmed in 6 patients undergoing RPLND. Compared with 37 stage-matched controls, there were no differences in length of stay, length of feeding tube dependence, net change in perioperative weight, or rates of hemorrhage and postoperative complications. RPLND altered adjuvant treatment recommendations in 1 of 30 patients.
RPLND is technically feasible by a purely transoral robotic approach. Its performance is not associated with worse swallowing outcomes or rates of complication. In select patients, RPLND may provide valuable staging information and guide the selection of adjuvant therapy.
评估咽后淋巴结对于口咽鳞状细胞癌（SCC）的治疗至关重要。经口机器人咽后淋巴结清扫术（RPLND）可在经口机器人手术（TORS）治疗模式中提供有价值的分期信息并指导辅助治疗的选择。
比较了30例患有口咽SCC且扁桃体原发灶的患者接受RPLND的结果与37例匹配分期但未接受RPLND的病例的结果。
6例接受RPLND的患者证实有咽后转移。与37例匹配分期的对照相比，住院时间、鼻饲管依赖时间、围手术期体重净变化或出血及术后并发症发生率均无差异。RPLND改变了30例患者中1例的辅助治疗建议。
单纯经口机器人方法进行RPLND在技术上是可行的。其实施与更差的吞咽结果或并发症发生率无关。在特定患者中，RPLND可提供有价值的分期信息并指导辅助治疗的选择。
