Predictors for Success and Failure in Transoral Robotic Surgery-A Retrospective Study in the North of the Netherlands

Transoral Robotic Surgery (TORS) is utilized for treating various malignancies, such as early-stage oropharyngeal cancer and lymph node metastasis of an unknown primary tumor (CUP), and also benign conditions, like obstructive sleep apnea (OSA) and chronic lingual tonsillitis. However, the success a...

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Bibliographic Details
Published in:Cancers 2024-04, Vol.16 (8), p.1458
Main Authors: Toppenberg, Alexandra G L, Nijboer, Thomas S, van der Laan, Wisse G W J, Wedman, Jan, Schwandt, Leonora Q, Plaat, Robert E, Witjes, Max J H, Wegner, Inge, Halmos, Gyorgy B
Format: Article
Language:English
Subjects:
Alcohol
Apnea
Benign
Comorbidity
Complications
Demography
Failure
Gender
Lymph nodes
Malignancy
Metastases
Oropharyngeal cancer
Otolaryngology
Pain
Patients
Postoperative
Radiation therapy
Robotic surgery
Sleep apnea
Sleep disorders
Surgical outcomes
Tonsillitis
Tumors
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Summary:Transoral Robotic Surgery (TORS) is utilized for treating various malignancies, such as early-stage oropharyngeal cancer and lymph node metastasis of an unknown primary tumor (CUP), and also benign conditions, like obstructive sleep apnea (OSA) and chronic lingual tonsillitis. However, the success and failure of TORS have not been analyzed to date. In this retrospective observational multicenter cohort study, we evaluated patients treated with TORS using the da Vinci surgical system. Success criteria were defined as identification of the primary tumor for CUP, >2 mm resection margin for malignant conditions, and improvement on respiratory polygraphy and tonsillitis complaints for benign conditions. A total of 220 interventions in 211 patients were included. We identified predictors of success, such as low comorbidity status ACE-27, positive P16 status, and lower age for CUP, and female gender and OSA severity for benign conditions. For other malignancies, no predictors for success were found. Predictors of failure based on postoperative complications included high comorbidity scores (ASA) and anticoagulant use, and for postoperative pain, younger age and female gender were identified. This study provides valuable insights into the outcomes and predictors of success and failure in TORS procedures across various conditions and may also help in patient selection and counseling.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers16081458