Paleri Vinidh, Fox Hannah, Coward Sarah, Ragbir Maniram, McQueen Andrew, Ahmed Omar, Meikle David, Saleh Daniel, O'Hara James, Robinson Max
Head and Neck Unit, The Royal Marsden Hospitals NHS Foundation Trust and Institute of Cancer Research, London, UK.
Department of Otolaryngology - Head and Neck Surgery, Newcastle upon Tyne Hospitals, Newcastle upon Tyne, UK.
Head Neck. 2018 Mar;40(3):512-525. doi: 10.1002/hed.25032. Epub 2017 Dec 15.
The purpose of this study was to identify the role of transoral robotic surgery (TORS) in the management of residual and recurrent oropharyngeal cancer.
IDEAL (Idea, Development, Exploration, Assessment, Long-term Follow-up) 2a framework.
Of 26 patients assessed for TORS, 21 underwent the procedure, 5 underwent open resection (4 due to unsuitable anatomy/tumor extent and 1 on the basis of patient choice). Three patients underwent intraoperative ultrasound-assisted robotic resection, and 3 received robotic-assisted free flap inset. A technical refinement for TORS of residual and recurrent oropharyngeal cancer of the tongue base is described. Actuarial plots showed estimated overall survival of 48.2%, local control of 76.6%, and disease-specific survival of 77.1% at 42.6 months.
TORS is a valid management option for residual and recurrent oropharyngeal cancer. Oncologic outcomes are comparable to open surgery and transoral laser microsurgery, with the added advantages of en bloc resections, facility for intraoperative ultrasound imaging, and inset of free flaps without mandibular split.
本研究的目的是确定经口机器人手术（TORS）在残留和复发性口咽癌治疗中的作用。
IDEAL（构思、开发、探索、评估、长期随访）2a框架。
在评估TORS的26例患者中，21例接受了该手术，5例接受了开放切除术（4例因解剖结构/肿瘤范围不合适，1例基于患者选择）。3例患者接受了术中超声辅助机器人切除术，3例接受了机器人辅助游离皮瓣植入。描述了一种针对舌根残留和复发性口咽癌的TORS技术改进。精算图显示，在42.6个月时，估计总生存率为48.2%，局部控制率为76.6%，疾病特异性生存率为77.1%。
TORS是残留和复发性口咽癌的一种有效治疗选择。肿瘤学结果与开放手术和经口激光显微手术相当，具有整块切除、术中超声成像便利以及无需劈开下颌即可植入游离皮瓣等额外优势。
