经头颈部上呼吸消化道放射治疗后行经口机器人手术的肿瘤学和功能学结果。法国 GETTEC 多中心研究组研究。
Oncological and functional outcomes for transoral robotic surgery following previous radiation treatment for upper aerodigestive tract head and neck cancers. A French multicenter GETTEC group study.
机构信息
Department of Otolaryngology Head and Neck Surgery, Nantes University Hospital, Nantes, France.
Nantes Université, CHU Nantes, Pôle Hospitalo-Universitaire 11: Santé Publique, Clinique des données, INSERM, CIC 1413, Nantes, France.
出版信息
Cancer Med. 2024 Apr;13(7):e7031. doi: 10.1002/cam4.7031.
BACKGROUND
Transoral robotic surgery (TORS) opens new perspectives. We evaluated the outcomes for patients having undergone TORS after previous radiotherapy.
METHODS
A retrospective multicenter study (n = 138) in a previously irradiated area between 2009 and 2020. Survival was assessed with the Kaplan-Meier method. Prognostic factors were evaluated using a chi-squared test, Fisher's test, or Wilcoxon's test.
RESULTS
The median length of hospital stay was 12.5 days. Bleeding was the most frequent postoperative complication (15.2%, n = 22). Prophylactic vessel ligation did not significantly decrease bleeding. Complications were significantly lower for Tis, T1, and N0 tumors. 91.6% (n = 120) of the patients with a perioperative tracheotomy could be decannulated. Larynx was functional for 65.94% of the patients. The median length of follow-up was 26 months. The 5-year overall and relapse-free survival rates were respectively 59.9% and 43.4%.
CONCLUSION
Oncological and functional results confirmed the value of TORS as a treatment in previously irradiated area.
背景
经口机器人手术（TORS）开辟了新的视角。我们评估了先前接受过放射治疗的患者接受 TORS 后的结果。
方法
这是一项 2009 年至 2020 年间在先前照射区域进行的回顾性多中心研究（n=138）。使用 Kaplan-Meier 方法评估生存率。使用卡方检验、Fisher 检验或 Wilcoxon 检验评估预后因素。
结果
中位住院时间为 12.5 天。出血是最常见的术后并发症（15.2%，n=22）。预防性血管结扎并不能显著减少出血。Tis、T1 和 N0 肿瘤的并发症明显较低。有围手术期气管切开术的 91.6%（n=120）的患者可以拔管。65.94%的患者的喉部功能正常。中位随访时间为 26 个月。5 年总生存率和无复发生存率分别为 59.9%和 43.4%。
结论
肿瘤学和功能学结果证实了 TORS 在先前照射区域作为治疗方法的价值。
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