Functional and oncological outcomes of salvage transoral robotic surgery : a comparative study
© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature..
PURPOSE: Transoral robotic surgery (TORS) as a first-line therapy has been well-documented but evidence is missing regarding salvage therapy. The aim of this study is to compare the oncological and functional outcomes of TORS as a primary and salvage therapy.
METHODS: This retrospective monocentric study included 74 patients operated by a single surgeon and sorted out into two groups: primary treatment (PT) or Salvage treatment (ST) in case of previous history of radiation therapy. Patients were further stratified by tumour location: larynx and pharynx (lST vs lPT and pST vs pPT).
RESULTS: Forty-eight patients were included in PT group (64.9%) and 26 in ST group (35.1%). ST patients had more frequent cTis/T1 tumours (57.7% vs 29.2%, p = 0.0164) and no clinical lymph disease (3.8% vs 37.5%, p = 0.0016). Tracheostomy was more often performed in the ST group (57.7% vs 16.7%, p = 0.0003) and the lST subgroup (88.9% vs 9.1%, p < 0.0001). Gastric feeding tube placement was more frequent in the ST group (76.9% vs 33.3%, p = 0.0003), the pST subgroup (64.7% vs 15.4%, p = 0.0009) and the lST subgroup (100% vs 54.5%, p = 0.0297). We observed a trend for more postoperative complications in the ST group (69.2% vs 47.9%, p = 0.0783). The overall survival was lower in the ST group (p = 0.0004), and in the pST subgroup (p < 0.0001). The disease-free survival rate was lower in the ST group (p = 0.0001), the pST subgroup (p = 0.0002) and the lST subgroup (p = 0.0328).
CONCLUSION: This study confirms that survival and functional outcomes after salvage TORS are worse than in first line surgery.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:279 |
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| Enthalten in: |
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery - 279(2022), 1 vom: 26. Jan., Seite 457-466 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Gazda, Pierre [VerfasserIn] |
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| Links: |
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| Themen: |
Head and neck cancer |
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| Anmerkungen: |
Date Completed 10.01.2022 Date Revised 10.01.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00405-021-06812-7 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM324350090 |
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| 520 | |a © 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. | ||
| 520 | |a PURPOSE: Transoral robotic surgery (TORS) as a first-line therapy has been well-documented but evidence is missing regarding salvage therapy. The aim of this study is to compare the oncological and functional outcomes of TORS as a primary and salvage therapy | ||
| 520 | |a METHODS: This retrospective monocentric study included 74 patients operated by a single surgeon and sorted out into two groups: primary treatment (PT) or Salvage treatment (ST) in case of previous history of radiation therapy. Patients were further stratified by tumour location: larynx and pharynx (lST vs lPT and pST vs pPT) | ||
| 520 | |a RESULTS: Forty-eight patients were included in PT group (64.9%) and 26 in ST group (35.1%). ST patients had more frequent cTis/T1 tumours (57.7% vs 29.2%, p = 0.0164) and no clinical lymph disease (3.8% vs 37.5%, p = 0.0016). Tracheostomy was more often performed in the ST group (57.7% vs 16.7%, p = 0.0003) and the lST subgroup (88.9% vs 9.1%, p < 0.0001). Gastric feeding tube placement was more frequent in the ST group (76.9% vs 33.3%, p = 0.0003), the pST subgroup (64.7% vs 15.4%, p = 0.0009) and the lST subgroup (100% vs 54.5%, p = 0.0297). We observed a trend for more postoperative complications in the ST group (69.2% vs 47.9%, p = 0.0783). The overall survival was lower in the ST group (p = 0.0004), and in the pST subgroup (p < 0.0001). The disease-free survival rate was lower in the ST group (p = 0.0001), the pST subgroup (p = 0.0002) and the lST subgroup (p = 0.0328) | ||
| 520 | |a CONCLUSION: This study confirms that survival and functional outcomes after salvage TORS are worse than in first line surgery | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Head and neck cancer | |
| 650 | 4 | |a Salvage treatment | |
| 650 | 4 | |a Swallowing disorders | |
| 650 | 4 | |a Tracheostomy | |
| 650 | 4 | |a Transoral robotic surgery | |
| 700 | 1 | |a Gauche, Clément |e verfasserin |4 aut | |
| 700 | 1 | |a Chaltiel, Léonor |e verfasserin |4 aut | |
| 700 | 1 | |a Chabrillac, Emilien |e verfasserin |4 aut | |
| 700 | 1 | |a Vairel, Benjamin |e verfasserin |4 aut | |
| 700 | 1 | |a De Bonnecaze, Guillaume |e verfasserin |4 aut | |
| 700 | 1 | |a Dupret-Bories, Agnès |e verfasserin |4 aut | |
| 700 | 1 | |a Filleron, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Vergez, Sébastien |e verfasserin |4 aut | |
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