Meta-analytic comparison of robotic and transoral laser surgical procedures in supraglottic carcinoma

Aşık, Mehmet Burak; Satar, Bülent; Serdar, Muhittin

doi:10.1017/s0022215119000707

Cited by 9 publications

(9 citation statements)

References 33 publications

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“…The oncological outcome reported in the literature between robotic‐assisted partial laryngectomy, endoscopic and open partial approaches are quite similar 11,36–40 . In our analysis, there was not a statistical survival advantage between the RT group and open PL + END.…”

Section: Discussionsupporting

confidence: 51%

Presentation and outcomes of patients with clinically T1‐2, N0 supraglottic squamous cell carcinoma: The role of definitive radiotherapy compared to primary partial laryngectomy

2021

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Background Early‐stage supraglottic squamous cell carcinoma (SCC) is usually treated with a single modality. The aim of this study is to examine the role of radiotherapy (RT) versus partial laryngectomy (open, robotic‐assisted, or endoscopic) with elective neck dissection (PL + END). Methods A retrospective analysis of the National Cancer Database, 2010–2016. The study population included adult patients with clinically T1‐2, N0 supraglottic SCC. Results 3301 patients were included. RT was performed in 93.52%, open PL + END in 2.64%, robotic‐assisted PL + END in 1.33%, and endoscopic surgical resection in 2.51%. In the surgery group, T was upstaged in 23.36% and N was upstage in 16.36%. Five‐year survival in the primary surgery group compared to RT group was 61.89% versus 77.46% (HR: 0.56, 95%CI: 0.43, 0.72). Conclusions T was upstaged in 23% of surgical patients. This accurate staging is likely missed in patients who undergo RT and possibly contributes to lower overall survival of this treatment group.

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Section: Discussionsupporting

confidence: 51%

Presentation and outcomes of patients with clinically T1‐2, N0 supraglottic squamous cell carcinoma: The role of definitive radiotherapy compared to primary partial laryngectomy

2021

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“…We observed that patients treated with TORS less frequently received adjuvant therapy (RT or CRT) compared to non‐robotic surgery. This trend has also been observed in studies of supraglottic and oropharyngeal SCC 12,36 . Further research is needed to understand if TORS resection could be used to de‐escalate treatment for early‐stage supraglottic carcinomas without adverse features.…”

Section: Discussionmentioning

confidence: 56%

Role of transoral robotic surgery in surgical treatment of early‐stage supraglottic larynx carcinoma

et al. 2023

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Background: There are several options for primary surgical treatment of early-stage supraglottic squamous cell carcinoma (SCC), including transoral robotic surgery (TORS). The purpose of this study was to compare outcomes of TORS to open partial laryngectomy and transoral laser microsurgery (TLM). Methods: Patients with clinical classification T1-2 supraglottic SCC diagnosed 2010-2019, treated with TORS, open partial laryngectomy, or TLM in the National Cancer Database were selected. Results: One thousand six hundred three patients were included: 17% TORS, 26.5% TLM, 56.5% open. TORS patients had the lowest rates of adjuvant treatment (28.4% vs. TLM: 45.0%, open: 38.5%, p < 0.001), and lower positive margin rates than TLM (16.9% vs. 30.5%, p < 0.001). Thirty-day and ninety-day post-operative mortality did not differ between the approaches. Five-year survival was higher following TORS compared to open surgery (77.8% vs. 66.1%, p = 0.01); this difference persisted following matched-pair analysis.Conclusions: TORS may be a safe and effective surgical approach for earlystage supraglottic SCC in appropriate patients.

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“…Overall survival and disease-free survival have already been shown to be equivocal amongst TLM and TORS patients with supraglottic cancer in a nonrandomized study. 40 Similarly, non-inferiority in terms of survival has been demonstrated in a meta-analysis for hypopharyngeal squamous cell carcinoma, comparing TORS to TLM. 41 Further randomized studies to assess this are certainly required; however, lack of precision in flexible CO 2 LASER remains a problem.…”

Section: Novel Developments In Lasersmentioning

confidence: 84%

<p>Novel Energy Devices in Head and Neck Robotic Surgery – A Narrative Review</p>

Ross¹,

Tolley²,

Awad³

2020

RSRR

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The advent of trans-oral robotic surgery (TORS) has facilitated removal of tumors previously deemed unresectable, by providing access to the deep structures of the head and neck. Despite this, the wider dissemination of TORS has been restricted due to issues with line of access, as the da Vinci robot was never designed with head and neck surgery in mind. Flexible instruments and novel energy delivery devices offer great potential in overcoming some of the existing challenges surrounding TORS. This review aimed to summarize the existing literature surrounding energy delivery in TORS and highlight areas of future innovation. MEDLINE was searched for studies relating to energy delivery in TORS in November 2019. The existing literature surrounding monopolar and bipolar electrocautery, LASER (CO 2 , Tm:YAG and blue LASER), Ligasure and Harmonic was reviewed. Additionally, the latest iteration of the da Vinci; the SP, and the FLEX robot were evaluated as novel methods of energy delivery in TORS. Overall, these novel energy devices and robotic systems are predicted to further improve energy delivery to the head and neck. The use of flexible LASER in particular is well substantiated in the literature. This has the potential to achieve treatment de-escalation, based on the excellent outcomes demonstrated for disease-free margins and post-operative morbidity.

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Meta-analytic comparison of robotic and transoral laser surgical procedures in supraglottic carcinoma

Cited by 9 publications

References 33 publications

Presentation and outcomes of patients with clinically T1‐2, N0 supraglottic squamous cell carcinoma: The role of definitive radiotherapy compared to primary partial laryngectomy

Presentation and outcomes of patients with clinically T1‐2, N0 supraglottic squamous cell carcinoma: The role of definitive radiotherapy compared to primary partial laryngectomy

Role of transoral robotic surgery in surgical treatment of early‐stage supraglottic larynx carcinoma

<p>Novel Energy Devices in Head and Neck Robotic Surgery – A Narrative Review</p>

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