What should we expect from robotic surgery for second primary oropharyngeal cancer?

• Published in: European archives of oto-rhino-laryngology 2017-08, Vol.274 (8), p.3161-3168
• Main Authors: Fang, Tuan-Jen, Lee, Li-Ang, Huang, Bing-Shan, Lin, Chien-Yu, Hsu, Cheng-Lung, Chang, Joseph Tung-Chieh, Yen, Tzu-Chen, Liao, Chun-Ta, Chiang, Hui-Chen
• Format: Article
• Language: English
• Subjects: Adult; Aged; Female; Head and Neck; Head and Neck Surgery; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Natural Orifice Endoscopic Surgery - adverse effects; Natural Orifice Endoscopic Surgery - methods; Neoplasm Staging; Neoplasms, Second Primary; Neurosurgery; Oropharyngeal Neoplasms - classification; Oropharyngeal Neoplasms - pathology; Oropharyngeal Neoplasms - surgery; Otorhinolaryngology; Outcome and Process Assessment (Health Care); Retrospective Studies; Robotic Surgical Procedures - adverse effects; Robotic Surgical Procedures - instrumentation; Robotic Surgical Procedures - methods; Robotics; Survival Analysis; Taiwan
• ISSN: 0937-4477; 1434-4726
• DOI: 10.1007/s00405-017-4594-8

The outcomes of second primary oropharyngeal cancer (SPOPC) may not be determined by oropharyngeal cancer but from the other index cancer as well. The management of (SPOPC) remains inconclusive and limited. Transoral robotic surgery (TORS) to maximize the functional outcomes without reducing oncologic effect is suggested as the primary treatment for selected oropharyngeal cancer. This study aimed to evaluate the feasibility and outcomes of TORS for the management of SPOPC. Patients who underwent TORS from January 2011 to June 2015 at a tertian referral center in Taiwan were recruited. Loco-regional status, overall survival (OS), disease-specific survival (DSS), and postoperative functional status were evaluated. Fifteen patients received TORS for SPOPC with curative intent, including eleven with tongue-base carcinomas, and four with tonsil carcinomas. One case was terminated because of inadequate exposure and the other 14 cases were completed with negative pathologic margins. Two-year OS and DSS were 53 and 77%, respectively. Patients with SPOPC occurring within 6 months had poorer outcomes ( p  = 0.044). The median time to feeding-tube removal was 5 days, and one patient had long-term gastric-tube dependence. Patients of age