The emerging role of trans-oral robotic surgery for the detection of the primary tumour site in patients with head-neck unknown primary cancers: A meta-analysis

• Published in: Auris, nasus, larynx nasus, larynx, 2019-10, Vol.46 (5), p.663-671
• Main Authors: Meccariello, Giuseppe, Cammaroto, Giovanni, Ofo, Enyinnaya, Calpona, Sebastiano, Parisi, Elisabetta, D’Agostino, Giovanni, Gobbi, Riccardo, Firinu, Elisabetta, Bellini, Chiara, De Vito, Andrea, Montevecchi, Filippo, Costantini, Matteo, Amadori, Elena, Nuzzo, Simona, Pelucchi, Stefano, Vicini, Claudio
• Format: Article
• Language: English
• Subjects: Head and Neck Neoplasms - diagnosis; Head and Neck Neoplasms - secondary; Head and Neck Neoplasms - surgery; Head neck; Humans; Lymph nodes; Lymph Nodes - pathology; Neck; Neoplasms, Unknown Primary - diagnosis; Neoplasms, Unknown Primary - surgery; Oropharyngeal Neoplasms - diagnosis; Oropharyngeal Neoplasms - pathology; Oropharyngeal Neoplasms - surgery; Papillomavirus Infections - diagnosis; Robotic; Robotic Surgical Procedures - methods; Squamous Cell Carcinoma of Head and Neck - diagnosis; Squamous Cell Carcinoma of Head and Neck - secondary; Squamous Cell Carcinoma of Head and Neck - surgery; Surgical procedures; Tongue Neoplasms - diagnosis; Tongue Neoplasms - pathology; Tongue Neoplasms - surgery; Unknown primary tumors
• ISSN: 0385-8146; 1879-1476
• DOI: 10.1016/j.anl.2019.04.007

The identification of the site in head neck unknown primary (HNUP) tumour is of utmost importance to help select best treatment while decreasing treatment-related morbidity and mortality. The primary purpose of this study is to demonstrate that TORS may be a valuable tool in detecting primary tumour. Studies were systematically searched in the PubMed, EMBASE, the Cochrane Library and CENTRAL electronic databases. A total of 12 selected studies (349 patients) were analyzed. The primary tumour detection and positive surgical margins rates were 70.8% and 19.4%, respectively. The rate of HPV-related tumour was 71.3%. The primary tumour was mainly in base of tongue (64%). In conclusion, TORS seems to be an effective surgical approach both in terms of detection of primary tumour site and in terms of therapeutic perspective for HNUP. In particular, a subset of HPV-related tumours might benefits all advantages from this surgical modality.