口腔机器人手术在口咽鳞状细胞癌治疗中的临床价值
[The clinical value of oral robotic surgery in the treatment of oropharyngeal squamous cell carcinoma].
作者信息
Zhang X, Yang Z Y, Yang A K, Zhang Q, Li Q L, Chen S W, Chen J T, Song M
机构信息
Department of Head and Neck Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.
出版信息
Zhonghua Zhong Liu Za Zhi. 2022 Jun 23;44(6):570-576. doi: 10.3760/cma.j.cn112152-20200731-00698.
To explore the therapeutic effects of transoral robotic surgery (TORS) and traditional surgical modes in oropharyngeal squamous cell carcinoma (OPSCC). The clinicopathological data of patients with oropharyngeal squamous cell carcinoma treated at Sun Yat-sen University Cancer Center from 2010 to 2018 were retrospectively analyzed. 135 cases were treated with traditional surgery (non-TORS group), while 52 cases were treated with TORS (TORS group). The prognosis of the two groups of patients were analyzed by Kaplan-Meier method and Log rank test, the influencing factors were analyzed by Cox regression model. The 2-year overall survival (OS, 94.2%) and 2-year progression-free survival (PFS, 93.8%) of patients in the TORS group were better than those in the non-TORS group (71.4% and 71.4%, respectively, <0.05). The 2-year OS (93.3%) and 2-year PFS (92.8%) of TORS group patients in T1-2 stage were better than those of non-TORS group (73.1% and 72.8%, respectively, <0.05). The 2-year OS (95.8%) and 2-year PFS (95.2%) of patients with stage Ⅰ to Ⅱ in the TORS group were not significantly different from those in the non-TORS group (84.1% and 83.9%, respectively, >0.05). The 2-year OS (92.9%) and 2-year PFS rate (92.7%) of patients with stage Ⅲ to Ⅳ in the TORS group were better than those in the non-TORS group (64.7% and 63.9%, respectively, <0.05). The 2-year OS (94.4%) of HPV-positive patients in the TORS group was not significantly different from that in the non-TORS group (83.3%, =0.222). The 2-year OS of HPV-negative patients in the TORS group (94.1%) was significantly different from that in the non-TORS group (43.7%, <0.001). HPV status was an independent prognostic factor (=0.008). TORS has a better prognosis in the treatment of oropharyngeal squamous cell carcinoma compared with the traditional treatment methods. The patients with T1-T2 can achieve better survival benefits after TORS treatment. The HPV-positive OPSCC patients has a better prognosis than that of HPV-negative OPSCC patients, and regardless of HPV status, OPSCC patients in the TORS group could obtain a better survival prognosis.
探讨经口机器人手术（TORS）与传统手术方式治疗口咽鳞状细胞癌（OPSCC）的疗效。回顾性分析2010年至2018年在中山大学肿瘤防治中心接受治疗的口咽鳞状细胞癌患者的临床病理资料。135例患者接受传统手术治疗（非TORS组），52例患者接受TORS治疗（TORS组）。采用Kaplan-Meier法和Log rank检验分析两组患者的预后，采用Cox回归模型分析影响因素。TORS组患者的2年总生存率（OS，94.2%）和2年无进展生存率（PFS，93.8%）优于非TORS组（分别为71.4%和71.4%，P<0.05）。T1-2期TORS组患者的2年OS（93.3%）和2年PFS（92.8%）优于非TORS组（分别为73.1%和72.8%，P<0.05）。TORS组Ⅰ至Ⅱ期患者的2年OS（95.8%）和2年PFS（95.2%）与非TORS组相比差异无统计学意义（分别为84.1%和83.9%，P>0.05）。TORS组Ⅲ至Ⅳ期患者的2年OS（92.9%）和2年PFS率（92.7%）优于非TORS组（分别为64.7%和63.9%，P<0.05）。TORS组HPV阳性患者的2年OS（94.4%）与非TORS组相比差异无统计学意义（83.3%，P=0.222）。TORS组HPV阴性患者的2年OS（94.1%）与非TORS组相比差异有统计学意义（43.7%，P<0.001）。HPV状态是独立的预后因素（P=0.008）。与传统治疗方法相比，TORS治疗口咽鳞状细胞癌的预后更好。T1-T2期患者接受TORS治疗后可获得更好的生存获益。HPV阳性的OPSCC患者预后优于HPV阴性的OPSCC患者，且无论HPV状态如何，TORS组的OPSCC患者均可获得更好的生存预后。
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