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早期人乳头瘤病毒阳性口咽鳞状细胞癌的经口机器人手术翻修:时机与切缘,过去与现在——一项前瞻性单中心观察性研究

Revision Transoral Robotic Surgery for Early Stage HPV Positive Oropharyngeal Squamous Cell Carcinoma, it's Timing and Margins: Past and Present- a Prospective Single Centre Observational Study.

作者信息

Kumar Sanjeev, Laugharne David, Mortimore Sean

机构信息

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.

出版信息

Indian J Otolaryngol Head Neck Surg. 2022 Dec;74(Suppl 3):6236-6240. doi: 10.1007/s12070-021-02926-w. Epub 2021 Nov 5.

Abstract

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.

摘要

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。

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1
Surgical Margin Determination in the Era of HPV-Positive Oropharyngeal Cancer.HPV 阳性口咽癌时代的手术切缘确定。
Laryngoscope. 2021 Oct;131(10):E2650-E2654. doi: 10.1002/lary.29533. Epub 2021 Apr 1.
2
Assessment of Surgeon Judgment during Resection of Laryngeal Carcinoma.喉癌切除术中外科医生判断力的评估
Iran J Otorhinolaryngol. 2020 Jul;32(111):223-227. doi: 10.22038/ijorl.2019.38025.2248.
9
Surgical margins in head and neck squamous cell carcinoma: what is 'close'?头颈部鳞状细胞癌的手术切缘:何为“近切缘”?
Eur Arch Otorhinolaryngol. 2013 Sep;270(10):2603-9. doi: 10.1007/s00405-012-2317-8. Epub 2012 Dec 28.

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