Transoral Robotic-Assisted Surgery for Head and Neck Squamous Cell Carcinoma

White, Hilliary N.; Moore, Eric J.; Rosenthal, Eben L.; Carroll, William R.; Olsen, Kerry D.; Desmond, Reneé A.; Magnuson, J. Scott

doi:10.1001/archoto.2010.216

Cited by 110 publications

(101 citation statements)

References 41 publications

(51 reference statements)

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“…Meanwhile, the 18-month recurrence-free survival rates were 78 % (for both groups) while the 2-year rates were 79 and 86.3 %, respectively. These early figures compared favorably to existing reports of OPC treated with chemoradiotherapy [24][25][26][27] yet the functional outcomes associated with transoral approaches are significantly better than chemoradiotherapy.…”

Section: Surgical Options For Treatment Of Opsccmentioning

confidence: 56%

“…The oncologic outcomes from TORS surgery for oropharyngeal cancer (OPC) are slowly emerging, and early outcomes seem promising [24][25][26][27]. In the studies to date, local failure rates vary between 0 and 3 %, with median follow-up rates ranging from 18 to 24 months [24][25][26][27].…”

Section: Surgical Options For Treatment Of Opsccmentioning

confidence: 99%

“…In the studies to date, local failure rates vary between 0 and 3 %, with median follow-up rates ranging from 18 to 24 months [24][25][26][27].…”

Section: Surgical Options For Treatment Of Opsccmentioning

confidence: 99%

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The Role for Surgical Management of HPV-Related Oropharyngeal Carcinoma

Genden

2012

Head and Neck Pathol

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Human papillomavirus (HPV)-associated oropharyngeal carcinoma has become the predominate cause of oropharyngeal carcinoma in the United States and Europe. Management of this disease is controversial. Traditional open surgical techniques gave way to concurrent chemoradiotherapy following several American and European organ-preservation trials suggesting that both modalities were equally efficacious. More recently, minimally invasive surgical techniques have gained popularity. These techniques provide an opportunity to achieve a complete surgical resection without the treatment-related morbidity associated with open surgery. Proponents of this technique contend that transoral surgical techniques provide a means to analyze the tumor tissue, prognosticate, and personally direct therapy. Skeptics suggest that HPVassociated oropharyngeal carcinoma responds well to chemoradiotherapy and that surgery may not provide a treatment advantage. Both approaches provide a unique perspective and both are currently being studied under trial.

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Section: Surgical Options For Treatment Of Opsccmentioning

confidence: 56%

Section: Surgical Options For Treatment Of Opsccmentioning

confidence: 99%

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The Role for Surgical Management of HPV-Related Oropharyngeal Carcinoma

Genden

2012

Head and Neck Pathol

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“…More than twenty studies on TORS in animals, cadavers, human subjects and various head and neck cancer sites have been published since 2005 [1][2][3][4]. A Pubmed search revealed several prospective studies based on series of at least 20 patients in the United States [5][6][7][8][9][10][11][12][13] and Australia [14] but only one European series [15] has been published in the literature.…”

Section: Introductionmentioning

confidence: 99%

Transoral robotic surgery for head and neck carcinomas

Hans

Badoual

Gorphe

et al. 2011

Eur Arch Otorhinolaryngol

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The objective of this study was prospectively to assess the feasibility and safety of transoral robotic surgery (TORS) in head and neck carcinomas and to report our learning curve and 2-year outcomes. Patients with oropharyngeal, hypopharyngeal and laryngeal tumors treated with TORS were prospectively included. We evaluated: the feasibility of TORS, robotic set-up time, transoral robotic surgery time, blood loss, surgical margins, tracheotomy, feeding tube, time to oral feeding and surgery-related complications. Twenty-three patients were treated for 25 carcinomas. Twenty-two patients underwent successful robotic resection for 24 carcinomas (96%). One patient required conversion to open surgery due to massive bleeding. The mean robotic set-up time was 25 min (range: 15-100 min) and mean TORS operating time was 70 min (range: 20-150 min). Positive margin of resection was observed in one patient (classified pT3) out of the 24 cancers and was managed by postoperative chemoradiation. No tracheotomy was performed. Three patients required prolonged intubation for a mean of 22 h. Two patients required a temporary gastrostomy (for 2 and 3.5 months, respectively). All other patients resumed oral feeding between the first and third postoperative day. The mean hospital stay was 6.4 days (range: 4-19 days). No postoperative complication occurred. Mean follow-up was 20 months (median: 19, range: 14-26). No death and no case of local or metastatic failure were observed. TORS is feasible and safe for the resection of selected head and neck carcinomas. The occurrence of intraoperative bleeding emphasizes the need for surgeons to be skilled in both transoral and open approaches.

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“…1 Previous studies have demonstrated its feasibility, lower morbidity rates, good functional outcomes, and comparable overall survival rates for patients with upper aerodigestive tract neoplasms. [2][3][4][5] With the introduction of any new technology or novel operative technique is an anticipated learning curve. As new institutions incorporate TORS into their everyday practice, it is helpful to have a timeline reference of expected goals to follow as their experience increases.…”

mentioning

confidence: 99%

Learning Curve for Transoral Robotic Surgery<subtitle>A 4-Year Analysis</subtitle><alt-title>Learning Curve for Transoral Robotic Surgery</alt-title>

White

Frederick²,

Zimmerman³

et al. 2013

JAMA Otolaryngol Head Neck Surg

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Importance:As new institutions incorporate transoral robotic surgery (TORS) into their everyday practice, it is helpful to have a timeline reference of expected goals to follow as their experience increases. This article evaluates a single tertiary care academic institution's experience with TORS for head and neck tumors and reports its 4-year learning curve.Objective: To evaluate a single institution's experience with TORS over a 4-year period and report treatment trends and clinical outcomes.Design: Prospective case study. Results: Significant decreases in operative time, length of intubation, and hospital stay were seen as TORS experience increased. Overall, the mean operative time decreased by 47% (group 4, 86 minutes; group 1, 183 minutes). Total mean intubation time decreased by 87% (group 1, 12.9 hours; group 4, 1.7 hours) and mean hospital stay decreased from 3.0 days to 1.4 days. There was not a significant difference between groups in number of cases unable to be performed robotically (7-9 per group), tumor stage (majority T1/T2), tumor subsite (majority oropharynx), positive margin status (2-5 per group), number of salvage cases performed (7-9 per group), and number of tracheostomies (2-4 per group) or feeding tubes (22-25 per group) required. Conclusions and Relevance:This is the first multiyear prospective study to document a single institution's TORS experience over time and demonstrate particular areas of expected improvement as case number increases.

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Transoral Robotic-Assisted Surgery for Head and Neck Squamous Cell Carcinoma

Abstract: the 2-year functional and oncologic results justify the continued treatment of select patients with head and neck squamous cell carcinoma with robotic-assisted surgical resection.

Cited by 110 publications

References 41 publications

The Role for Surgical Management of HPV-Related Oropharyngeal Carcinoma

The Role for Surgical Management of HPV-Related Oropharyngeal Carcinoma

Transoral robotic surgery for head and neck carcinomas

Learning Curve for Transoral Robotic Surgery<subtitle>A 4-Year Analysis</subtitle><alt-title>Learning Curve for Transoral Robotic Surgery</alt-title>

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