Treatment outcomes of neoadjuvant chemotherapy and transoral robotic surgery in locoregionally advanced laryngopharyngeal carcinoma

Abstract

Background: We aimed to identify the optimal indications of neoadjuvant chemotherapy (NACT) and transoral robotic surgery (TORS) in patients with locoregionally advanced (T3-4 or N2-3) head and neck cancer (HNC).Methods: A total of 50 patients were included in the study. Results: T1 was identified in seven cases, T2 in 19, T3 in 22, and T4 in 2. N0 was identified in nine cases, N1 in 18, N2 in 22, and N3 in 1. There were 25 patients (50%) with complete remission of the primary lesion and 25 patients (50%) with partial remission. On pathologic examination of surgical specimens after neoadjuvant chemotherapy and TORS, 2 patients (4%) had a positive surgical margin, and 48 patients (96%) had a negative margin. Pathologic metastatic lymph nodes (LNs) were not observed in 39 cases (78%), and one metastatic LN was observed in 11 cases (22%). The 3-year recurrence-free survival (RFS) of all patients was 85.4%. On multivariate analysis, lymphovascular invasion showed a significant correlation with RFS. Conclusions:In patients with locoregionally advanced HNC, NACT and TORS achieved favorable oncologic and functional outcomes.

Long-Term Treatment Outcomes of Hypopharyngeal Cancer Using Different Surgical Modalities

“…Transoral surgery combined with NAC has been performed for advanced HPSCC, and favorable oncological and functional outcomes have been reported. [8][9][10] In our institution, both classical surgery and transoral surgery combined with NAC are used to treat HNSCC patients. Since OPEN TORS Fig.…”

“…Studies have reported outcomes of transoral surgery and compared its oncological and functional results with conventional treatments. [8][9][10] In the case of advanced HPSCC, new therapies combining neoadjuvant chemotherapy (NAC) and transoral robotic surgery (TORS) have shown promising oncological and functional outcomes. However, limitations such as single-institution studies and retrospective designs introduce selection bias, and comprehensive investigations on HPSCC's natural course, prognostic factors, and treatment results are lacking due to the low incidence of HPSCC.…”

Surgical margins in head and neck squamous cell carcinoma: a narrative review

“…Its advantages include a wider 3D magnified view, the capacity to visualize ‘around the corner’, and finely controlled movements facilitated by flexible robotic arms and a tremor-filtering system 259 , 260 . Compared to traditional open treatment, transoral robotic surgery offers a minimally invasive approach, expediting patient recovery and improving aesthetic and functional preservation 261 – 263 . However, transoral robotic surgery can be more time-consuming than conventional surgery, necessitates a substantial initial investment, and presents a steep learning curve for surgeons 264 .…”