Transoral Robotic Surgery for Advanced Oropharyngeal Carcinoma

摘要: Objectives To determine the oncologic and functional outcomes in patients undergoing primary transoral robotic surgery followed by adjuvant therapy as indicated with a minimum of 18-month follow-up for advanced oropharyngeal carcinoma. Design Prospective single-center cohort study. Setting Academic university health system tertiary referral center. Patients Forty-seven adults newly diagnosed previously untreated Intervention Transoral staged neck dissection indicated. Main Outcome Measures Margin status, recurrence, disease-specific disease-free survival, gastrostomy tube dependence, safety efficacy end points. Results In 47 enrolled stages III IV carcinoma, mean was 26.6 months. There no intraoperative or postoperative mortality. Resection margins were positive 1 patient (2%). At last follow-up, local recurrence identified (2%), regional 2 (4%), distant 4 (9%). Disease-specific survival 98% (45 46 patients) at year 90% (27 30 years. Based on pathologic risk stratification, 18 (38%) avoided chemotherapy, 5 (11%) did not receive radiotherapy concurrent chemotherapy their treatment regimen. year, only required tube. Conclusions This novel regimen offers disease control, commensurate standard treatments an unexpected beneficial outcome dependency rates that are markedly lower than those reported nonsurgical therapies.