2020Laryngo-Rhino-OtologieOpen access

Transoral laser microsurgery vs. transoral robotic surgery for the resection of oropharyngeal squamous cell carcinoma

Matti Sievert, Mariana Gonçalves, Ali Zbidat, Antoniu‐Oreste Gostian, Heinrich Iro

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Abstract

Introduction Transoral robotic surgery (TORS) has been attributed to significant advances in the treatment of oropharyngeal cancer (OPSCC) since its first description in 2007. Especially in T1/T2 tumors involving the base of the tongue, this method is compared to transoral laser microsurgery (TLM). Aim: Evaluation of oncological and functional results of OPSCC therapy with TLM and TORS (DaVinci®). Methods Retrospective analysis of all patients with OPSCC treated with TLM (n = 30) or TORS (n = 24) between April 2003 and May 2018 (follow-up 43 ± 38.3 months). Results Both groups were homogeneous in terms of TNM and UICC stage (p = 0.818), p16 status (p = 0.671) and type of adjuvant treatment (p = 0.133). There were no significant differences (TORS vs. TLM) in the duration of surgery (276min vs. 250min, p = 0.471), duration of hospitalization (14.9 vs. 16.6 days, p = 0.549), time in intensive care (1.5 vs. 2.4 days, p = 0.80), tracheotomy frequency (43.3 % vs. 45.8 %, p = 0.114), percutaneous endoscopic gastrostomy rate (36.7 % vs. 50 %, p = 0.325), and postoperative bleeding rate (6.7 % vs. 16.7 %, p = 0.245). Local relapses occurred in three and two patients after an average of 35.7 months (TLM) and 26.5 months (TORS), respectively (p = 0.834). Four patients showed distant metastasis after an average of 41.5 months (TLM) and one patient after 13 months (TORS) (p = 0.248). Disease-free survival was 86.7 % and 87.5 %, respectively (Kaplan-Maier, p = 0.833). Conclusion TLM and TORS achieved equivalent oncological and functional results associated with comparable perioperative risks. Poster-PDF A-1201.PDF Publication History Article published online: 10 June 2020 © 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). © Georg Thieme Verlag KG Stuttgart · New York

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Introduction Transoral robotic surgery (TORS) has been attributed to significant advances in the treatment of oropharyngeal cancer (OPSCC) since its first description in 2007. Especially in T1/T2 tumors involving the base of the tongue, this method is compared to transoral laser microsurgery (TLM). Aim: Evaluation of oncological and functional results of OPSCC therapy with TLM and TORS (DaVinci®). Methods Retrospective analysis of all patients with OPSCC treated with TLM (n = 30) or TORS (n = 24) between April 2003 and May 2018 (follow-up 43 ± 38.3 months). Results Both groups were homogeneous in terms of TNM and UICC stage (p = 0.818), p16 status (p = 0.671) and type of adjuvant treatment (p = 0.133). There were no significant differences (TORS vs. TLM) in the duration of surgery (276min vs. 250min, p = 0.471), duration of hospitalization (14.9 vs. 16.6 days, p = 0.549), time in intensive care (1.5 vs. 2.4 days, p = 0.80), tracheotomy frequency (43.3 % vs. 45.8 %, p = 0.114), percutaneous endoscopic gastrostomy rate (36.7 % vs. 50 %, p = 0.325), and postoperative bleeding rate (6.7 % vs. 16.7 %, p = 0.245). Local relapses occurred in three and two patients after an average of 35.7 months (TLM) and 26.5 months (TORS), respectively (p = 0.834). Four patients showed distant metastasis after an average of 41.5 months (TLM) and one patient after 13 months (TORS) (p = 0.248). Disease-free survival was 86.7 % and 87.5 %, respectively (Kaplan-Maier, p = 0.833). Conclusion TLM and TORS achieved equivalent oncological and functional results associated with comparable perioperative risks. Poster-PDF A-1201.PDF Publication History Article published online: 10 June 2020 © 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). © Georg Thieme Verlag KG Stuttgart · New York

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Available abstract

Introduction Transoral robotic surgery (TORS) has been attributed to significant advances in the treatment of oropharyngeal cancer (OPSCC) since its first description in 2007. Especially in T1/T2 tumors involving the base of the tongue, this method is compared to transoral laser microsurgery (TLM). Aim: Evaluation of oncological and functional results of OPSCC therapy with TLM and TORS (DaVinci®). Methods Retrospective analysis of all patients with OPSCC treated with TLM (n = 30) or TORS (n = 24) between April 2003 and May 2018 (follow-up 43 ± 38.3 months). Results Both groups were homogeneous in terms of TNM and UICC stage (p = 0.818), p16 status (p = 0.671) and type of adjuvant treatment (p = 0.133). There were no significant differences (TORS vs. TLM) in the duration of surgery (276min vs. 250min, p = 0.471), duration of hospitalization (14.9 vs. 16.6 days, p = 0.549), time in intensive care (1.5 vs. 2.4 days, p = 0.80), tracheotomy frequency (43.3 % vs. 45.8 %, p = 0.114), percutaneous endoscopic gastrostomy rate (36.7 % vs. 50 %, p = 0.325), and postoperative bleeding rate (6.7 % vs. 16.7 %, p = 0.245). Local relapses occurred in three and two patients after an average of 35.7 months (TLM) and 26.5 months (TORS), respectively (p = 0.834). Four patients showed distant metastasis after an average of 41.5 months (TLM) and one patient after 13 months (TORS) (p = 0.248). Disease-free survival was 86.7 % and 87.5 %, respectively (Kaplan-Maier, p = 0.833). Conclusion TLM and TORS achieved equivalent oncological and functional results associated with comparable perioperative risks. Poster-PDF A-1201.PDF Publication History Article published online: 10 June 2020 © 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). © Georg Thieme Verlag KG Stuttgart · New York

Key concepts: Transoral laser microsurgery, Transoral robotic surgery, Medicine, Microsurgery, Basal cell, Laser surgery, Tongue, Surgery

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Transoral laser microsurgery vs. transoral robotic surgery for the resection of oropharyngeal squamous cell carcinoma — Research Paper | ScholarLens