Kumar Sanjeev, Laugharne David, Mortimore Sean
Department of Otolaryngology & Head and Neck Surgery, University Hospitals of Derby and Burton NHS Trust, Royal Derby Hospital, Uttoxeter New Road, Derby, DE22 3NE UK.
Department of Maxillofacial & Head and Neck Surgery, University Hospitals of Derby and Burton NHS Trust, Royal Derby Hospital, Uttoxeter New Road, Derby, DE22 3NE UK.
Indian J Otolaryngol Head Neck Surg. 2022 Dec;74(Suppl 3):6236-6240. doi: 10.1007/s12070-021-02926-w. Epub 2021 Nov 5.
To review cohort of patients with HPV positive early stage oropharyngeal cancer that underwent revision trans oral robotic surgery for positive or close margin for evidence of residual disease, its impact on survival and discussion about clear margin. This is a prospective observational study. Our TORS revision rate was 20.6%. 91.7% did not need radiotherapy to primary site; mean recurrence free survival is 31 months and no mortality in this cohort due to the primary disease. There is no consensus on what is clear margin. The surgical margins are a surrogate marker for later recurrences or long-term survival and this is what guides our treatment but equally attempts should be made to preserve their function and not increase the morbidity.
回顾接受经口机器人手术翻修术治疗切缘阳性或接近阳性以证实有残留疾病的HPV阳性早期口咽癌患者队列，探讨其对生存的影响并讨论切缘阴性问题。这是一项前瞻性观察性研究。我们的经口机器人手术翻修率为20.6%。91.7%的患者不需要对原发部位进行放疗；该队列的平均无复发生存期为31个月，且无因原发性疾病导致的死亡。对于什么是切缘阴性尚无共识。手术切缘是后期复发或长期生存的替代指标，这指导着我们的治疗，但同样应努力保留其功能且不增加发病率。
