Minimizing adjuvant treatment after transoral robotic surgery through surgical margin revision and exclusion of radiographic extracapsular extension: A Prospective observational cohort study.

Details

Serval ID
serval:BIB_923FC2198B46
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Minimizing adjuvant treatment after transoral robotic surgery through surgical margin revision and exclusion of radiographic extracapsular extension: A Prospective observational cohort study.
Journal
Head & neck
Author(s)
Morisod B., Venara-Vulpe I.I., Alzuphar S., Monnier Y., Bongiovanni M., Hagmann P., Bouchaab H., Bourhis J., Simon C.
ISSN
1097-0347 (Electronic)
ISSN-L
1043-3074
Publication state
Published
Issued date
05/2017
Peer-reviewed
Oui
Volume
39
Number
5
Pages
965-973
Language
english
Notes
Publication types: Journal Article ; Observational Study
Publication Status: ppublish
Abstract
We investigated in a prospective cohort of patients treated with trans-oral robotic surgery (TORS) for oropharyngeal cancer (OPC), who were selected for the absence of radiographic extra-capsular extension (ECS) and surgically revised for inadequate margins, the possibility of reducing adjuvant radiation (RT)/chemo-radiation therapy (CRT) without jeopardizing tumor control and functional outcome.
We conducted a prospective observational cohort of patients treated with TORS for oropharyngeal cancer.
Twenty-nine patients with T1/2N0 to N2B stage cancers were treated with TORS. Forty-five percent of them were treated for secondary primaries. Nine of 29 patients (31%) were revised for close/positive margins. Adjuvant RT was prescribed for 2 of 19 patients with early squamous cell carcinoma (SCCs) and CRT for 1 of 10 patients with advanced oropharyngeal SCCs. Overall survival (OS), disease-specific survival (DSS), and locoregional control at 2 years were 85%, 96%, and 93%, respectively. Posttreatment Functional Outcome Swallowing Scale (FOSS) scores worsened with prior or adjuvant RT, local recurrence, site, and revision for margins.
Patients with early and moderately advanced oropharyngeal SCC selected for radiographic ECS and revised for inadequate margins have excellent tumor control and favorable functional recovery. © 2017 Wiley Periodicals, Inc. Head Neck 39: 965-973, 2017.

Keywords
Aged, Carcinoma, Squamous Cell/mortality, Carcinoma, Squamous Cell/pathology, Carcinoma, Squamous Cell/therapy, Female, Humans, Male, Margins of Excision, Middle Aged, Oropharyngeal Neoplasms/mortality, Oropharyngeal Neoplasms/pathology, Oropharyngeal Neoplasms/therapy, Prospective Studies, Radiotherapy, Adjuvant, Robotic Surgical Procedures, Survival Rate, Treatment Outcome, Functional Outcome Swallowing Scale (FOSS) score, head and neck cancer, head and neck squamous cell carcinoma (HNSCC), oropharyngeal neoplasm, transoral robotic surgery (TORS)
Pubmed
Web of science
Create date
13/02/2017 10:37
Last modification date
20/08/2019 15:55
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