经口机器人手术治疗人乳头瘤病毒阴性口咽鳞状细胞癌：肿瘤学及功能结局随访
Trans Oral Robotic Surgery for HPV-Negative Oropharyngeal Squamous Cell Carcinoma: Follow-Up on Oncological and Functional Outcomes.
作者信息
Azalmad Khalid, Lambercy Karma, Beharry Avinash, Piazzon Nathalie, Barbesier Marie, Dalla-Vale Margaux, Moraru Manuela, Berezowska Sabina, Simon Christian
机构信息
Department of Otolaryngology-Head and Neck Surgery, CHUV, University of Lausanne, Lausanne, Switzerland.
Department of Laboratory Medicine and Pathology, Institute of Pathology, CHUV, University of Lausanne, Lausanne, Switzerland.
出版信息
Head Neck. 2025 Mar;47(3):791-800. doi: 10.1002/hed.27958. Epub 2024 Oct 14.
BACKGROUND
The efficacy of transoral robotic surgery (TORS) for HPV-negative oropharyngeal cancers (OPSCC) is less explored, especially regarding long-term outcomes and prognostic factors.
METHODS
We conducted a retrospective monocentric study on 37 patients with HPV-negative OPSCC treated with TORS with a median follow-up of 3 years, assessing survival outcomes using Kaplan-Meyer statistics and swallowing function via the functional outcome swallowing scale (FOSS). Histopathological parameters were collected either from medical records or histology slides were re-evaluated.
RESULTS
Patients demonstrated high disease-specific survival (DSS) but lower overall survival (OS), with a cohort characterized by high comorbidity rates. Vascular invasion was a significant adverse factor for relapse-free survival (RFS) and OS, while lymphatic invasion was not. Most patients demonstrated significant preservation of swallowing function.
CONCLUSIONS
TORS for HPV-negative OPSCC demonstrates high DSS and preserved swallowing function. Vascular invasion is a key prognostic factor for survival outcomes.
背景
经口机器人手术（TORS）治疗人乳头瘤病毒（HPV）阴性口咽癌（OPSCC）的疗效鲜少被探究，尤其是关于长期预后及预后因素。
方法
我们对37例接受TORS治疗的HPV阴性OPSCC患者进行了一项回顾性单中心研究，中位随访时间为3年，采用Kaplan-Meier统计法评估生存结局，并通过吞咽功能结局量表（FOSS）评估吞咽功能。组织病理学参数要么从病历中收集，要么对组织学切片进行重新评估。
结果
患者显示出较高的疾病特异性生存率（DSS），但总生存率（OS）较低，该队列的特点是合并症发生率高。血管侵犯是无复发生存率（RFS）和OS的显著不利因素，而淋巴侵犯则不是。大多数患者的吞咽功能得到了显著保留。
结论
TORS治疗HPV阴性OPSCC显示出较高的DSS和保留的吞咽功能。血管侵犯是生存结局的关键预后因素。
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