Nilsson Johan S, Wahlberg Peter, Greiff Lennart
Department of ORL, Head and Neck Surgery, Skåne University Hospital, Lund, Sweden.
Department of Clinical Sciences, Lund University, Lund, Sweden.
Acta Otolaryngol. 2020 Jan;140(1):85-88. doi: 10.1080/00016489.2019.1688863. Epub 2019 Nov 18.
Transoral robotic surgery (TORS) assisted base of the tongue (BOT) resection has been suggested as part of the work-up for head and neck squamous cell cancer with unknown primary (HNSCC-CUP). Success rates vary with regard to identification of primary BOT lesions, and cases with likely such lesions appear to be included in previous reports. To analyse the possible benefits of a superficial TORS-assisted BOT resection in thoroughly investigated HNSCC-CUP. Retrospectively, 13 patients subjected to superficial TORS-assisted BOT resections due to HNSCC-CUP, where previous thorough work-ups including PET-scans had been performed and primary lesions had still not been identified, were reviewed. Nodal status, according to the TNM-8 classification, was N1, N2, N2a, N2b, N2c, and N3, respectively, for 7, 1, 1, 4, 0, and 0 patients. In 38% of the cases, T1 BOT cancers were identified using superficial TORS-assisted BOT resections and treatments adjusted. Addition of a superficial TORS-assisted BOT resection to the work-up of HNSCC-CUP frequently identifies primary lesions and alters the treatment for this group of patients even after thorough work-up.
经口机器人手术（TORS）辅助舌根部（BOT）切除术已被建议作为不明原发灶的头颈部鳞状细胞癌（HNSCC-CUP）检查的一部分。在识别原发性BOT病变方面成功率各不相同，并且之前的报告似乎纳入了可能存在此类病变的病例。为分析在全面检查的HNSCC-CUP中进行浅表TORS辅助BOT切除术可能带来的益处。回顾性分析了13例因HNSCC-CUP接受浅表TORS辅助BOT切除术的患者，这些患者之前已进行了包括PET扫描在内的全面检查，但仍未发现原发性病变。根据TNM-8分类，7例、1例、1例、4例、0例和0例患者的淋巴结状态分别为N1、N2、N2a、N2b、N2c和N3。在38%的病例中，通过浅表TORS辅助BOT切除术识别出T1期BOT癌并调整了治疗方案。在HNSCC-CUP的检查中增加浅表TORS辅助BOT切除术，即使在全面检查后，也经常能识别出原发性病变并改变该组患者的治疗方案。
