经口机器人手术治疗 HPV 阴性口咽癌的肿瘤学结果。
Oncologic outcomes of transoral robotic surgery for HPV-negative oropharyngeal carcinomas.
机构信息
Department of Otorhinolaryngology - Head & Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
出版信息
Head Neck. 2021 Oct;43(10):2923-2934. doi: 10.1002/hed.26776. Epub 2021 Jun 8.
BACKGROUND
Patients with human papillomavirus (HPV)-negative oropharyngeal squamous cell carcinoma (OPSCC) continue to experience disappointing outcomes following chemoradiotherapy (CRT) and appreciable morbidity following historical surgical approaches. We aimed to investigate the oncologic outcomes and perioperative morbidity of a transoral robotic surgery (TORS) approach to surgically resectable HPV-negative OPSCC.
METHODS
Retrospective analysis HPV-negative OPSCC patients who underwent TORS, neck dissection and pathology-guided adjuvant therapy (2005-2017).
RESULTS
Fifty-six patients (91.1% stage III/IV) were included. Three-year overall survival, locoregional control, and disease-free survival were 85.5%, 84.4%, and 73.6%, respectively (median follow-up 30.6 months, interquartile range 18.4-66.6). Eighteen (32.1%) patients underwent adjuvant radiotherapy and 20 (39.3%) underwent adjuvant CRT. Perioperative mortality occurred in one (1.8%) patient and hemorrhage occurred in two (3.6%) patients. Long-term gastrostomy and tracheostomy rates were 5.4% and 0.0%, respectively.
CONCLUSION
The TORS approach for resectable HPV-negative OPSCC can achieve encouraging oncologic outcomes with infrequent morbidity.
背景
人乳头瘤病毒（HPV）阴性口咽鳞状细胞癌（OPSCC）患者在接受放化疗（CRT）后仍持续出现令人失望的结果，并且在历史上的手术方法后会出现相当大的发病率。我们旨在研究经口机器人手术（TORS）方法对可手术切除的 HPV 阴性 OPSCC 的肿瘤学结果和围手术期发病率。
方法
回顾性分析了 2005 年至 2017 年间接受 TORS、颈部清扫术和病理指导辅助治疗的 HPV 阴性 OPSCC 患者。
结果
56 例患者（91.1%为 III/IV 期）被纳入研究。三年总生存率、局部区域控制率和无病生存率分别为 85.5%、84.4%和 73.6%（中位随访 30.6 个月，四分位距 18.4-66.6）。18 例（32.1%）患者接受辅助放疗，20 例（39.3%）患者接受辅助 CRT。1 例（1.8%）患者发生围手术期死亡，2 例（3.6%）患者发生出血。长期胃造口和气管造口的发生率分别为 5.4%和 0.0%。
结论
对于可切除的 HPV 阴性 OPSCC，TORS 方法可实现令人鼓舞的肿瘤学结果，且发病率较低。
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