Department of Surgical Oncology, Head & Neck Unit, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Department of Surgical Oncology, Head & Neck Unit, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2021 Jul;132(1):18-25. doi: 10.1016/j.oooo.2021.01.013. Epub 2021 Jan 15.
Limited data are currently available regarding outcomes following transoral robotic surgery (TORS) in the salvage setting. This study aims to investigate the functional and oncological outcomes following TORS in salvage oropharyngeal tumors.
All patients undergoing salvage TORS for a residual, recurrent, or new primary oropharyngeal squamous cell carcinoma within a previously radiated field between March 2014 and October 2018 were included. Patients undergoing salvage TORS for other subsites were excluded. Margin status, complication rates, long-term tracheostomy, and gastrostomy requirements and overall and disease-free survival outcomes were recorded.
A total of 26 patients were included. Three patients (11%) experienced a TORS-specific major complication. A gastrostomy tube was required in 42% of patients on discharge (n = 11), and in 28% of patients on long-term follow-up (n = 7) at a median of 34 (interquartile range, 11.8-47.8) months. A tracheostomy was placed in 5 patients and all were removed before discharge. The 3-year overall survival and disease-free survival were 74% and 70%, respectively.
Salvage TORS is a viable and effective option in the management of selected tumors within a previously radiated field.
目前关于经口机器人手术（TORS）在挽救性治疗中的结果数据有限。本研究旨在调查经口机器人手术治疗既往放疗野内残留、复发或新发原发或口咽鳞状细胞癌的功能和肿瘤学结果。
所有在 2014 年 3 月至 2018 年 10 月期间因既往放疗野内残留、复发或新发原发或口咽鳞状细胞癌而行挽救性 TORS 的患者均纳入本研究。因其他部位而行挽救性 TORS 的患者被排除在外。记录边缘状态、并发症发生率、长期气管造口和胃造口需求以及总生存率和无病生存率。
共纳入 26 例患者。3 例患者（11%）发生 TORS 特异性严重并发症。11 例患者（42%）在出院时需要胃造口管，7 例患者（28%）在中位时间为 34 个月（四分位距 11.8-47.8）的长期随访时需要胃造口管。5 例患者行气管造口术，所有患者在出院前均拔除。3 年总生存率和无病生存率分别为 74%和 70%。
挽救性 TORS 是既往放疗野内选择肿瘤的一种可行且有效的治疗选择。
