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经口机器人手术在口咽鳞状细胞癌治疗中的应用

[Application of transoral robotic surgery in treatment of oropharyngeal squamous cell carcinoma].

作者信息

Zhang X, Chen S W, Yang Z Y, Chen J T, Su X, Yang A K, Song M

机构信息

Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China.

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 May 7;57(5):545-551. doi: 10.3760/cma.j.cn115330-20210731-00505.

Abstract

To evaluate the therapeutic and prognostic outcomes of transoral robotic surgery (TORS) for oropharyngeal squamous cell carcinoma (OSCC). A retrospective study of 99 OSCC patients treated with TORS in Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center between April 2017 and May 2021 was conducted. There were 84 males and 15 females, with an age range of 35-85 years. Patients' clinical characteristics, including clinical staging, HPV infection status, perioperative management and postoperative adjuvant treatment, were recorded. The overall survival (OS) and progression-free survival (PFS) were analyzed. The survival outcomes were analyzed with Kaplan-Meier method and Log-rank test. The hospital stay of OSCC patients with TORS was (5.3±2.9) days and the average time of postoperative nasal feeding tube indwelling was (15.2±10.8) days. Among the 99 patients, 21 (21.2%) received tracheotomy and the average time of tracheotomy tube indwelling was (11.9±11.4) days. The two-year OS and PFS in patients with follow-up over two years were 94.0% and 87.7%, respectively and the three-year OS and PFS of patients with follow-up over three years were 94.0% and 78.9%, respectively. The two-year OS and PFS were respectively 97.4% and 88.9%, for patients with stages I-II and 86.8% and 88.9% for patients with stages III-IV. HPV-negative and HPV-positive patients had respectively two-year OS (100.0% 91.5%) and PFS (88.9% 87.2%). There was no significantly statistical difference in survival between patients with and without adjuvant radiotherapy after TORS (82.6% . 90.5%, =0.52, 95%: 0.12-2.23, =0.400). TORS is more suitable for the treatment of patients with early (Ⅰ-Ⅱ) or HPV-positive oropharyngeal squamous cell carcinoma, and the recovery after TORS treatment is good.

摘要

评估经口机器人手术(TORS)治疗口咽鳞状细胞癌(OSCC)的疗效及预后。对2017年4月至2021年5月期间在中山大学肿瘤防治中心头颈外科接受TORS治疗的99例OSCC患者进行回顾性研究。其中男性84例,女性15例,年龄范围为35 - 85岁。记录患者的临床特征,包括临床分期、HPV感染状态、围手术期管理及术后辅助治疗情况。分析总生存期(OS)和无进展生存期(PFS)。采用Kaplan-Meier法和Log-rank检验分析生存结局。接受TORS治疗的OSCC患者住院时间为(5.3±2.9)天,术后鼻饲管留置平均时间为(15.2±10.8)天。99例患者中,21例(21.2%)接受了气管切开术,气管切开管留置平均时间为(11.9±11.4)天。随访超过两年的患者两年OS和PFS分别为94.0%和87.7%,随访超过三年的患者三年OS和PFS分别为94.0%和78.9%。Ⅰ - Ⅱ期患者两年OS和PFS分别为97.4%和88.9%,Ⅲ - Ⅳ期患者分别为86.8%和88.9%。HPV阴性和HPV阳性患者两年OS分别为(100.0%和91.5%),PFS分别为(88.9%和87.2%)。TORS术后接受辅助放疗与未接受辅助放疗患者的生存情况无显著统计学差异(82.6%对90.5%,P = 0.52,95%CI:0.12 - 2.23,P = 0.400)。TORS更适合治疗早期(Ⅰ - Ⅱ期)或HPV阳性的口咽鳞状细胞癌患者,且TORS治疗后恢复良好。

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[Application of transoral robotic surgery in treatment of oropharyngeal squamous cell carcinoma].经口机器人手术在口咽鳞状细胞癌治疗中的应用
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 May 7;57(5):545-551. doi: 10.3760/cma.j.cn115330-20210731-00505.

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