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Transoral robotic surgery for oropharyngeal carcinoma: Surgical margins and oncologic outcomes
Author(s) -
Moore Eric J.,
Abel Kathryn M.,
Price Daniel L.,
Lohse Christine M.,
Olsen Kerry D.,
Jackson Ryan S.,
Martin Eliot J.
Publication year - 2018
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.25055
Subject(s) - medicine , interquartile range , transoral robotic surgery , confidence interval , surgery , carcinoma , cancer , adjuvant therapy , comorbidity , oncology
Background This study presents oncologic outcomes after transoral robotic surgery (TORS) ± adjuvant therapy for oropharyngeal squamous cell carcinoma (SCC). Methods Three hundred fourteen patients undergoing TORS ± adjuvant therapy for oropharyngeal SCC from May 1, 2007, to May 31, 2015, are analyzed. Results Median follow‐up was 3.3 years (interquartile range [IQR] 1.8‐5.3 years; range 1 day to 9.3 years). Estimated locoregional recurrence‐free survival, distant metastasis‐free survival (DMFS), overall survival (OS), and cancer‐specific survival (CSS) rates (95% confidence interval [CI] number still at risk) at 5 years after surgery were 92% (88‐95; 92), 90% (86‐94; 92), 86% (82‐92; 98), and 94% (91‐97; 98), respectively. Negative margins were achieved in 98% of cases. The adult comorbidity evaluation (ACE)‐27 comorbidity index, human papillomavirus (HPV) status, pathologic N classification, and number of attempts to clear margins were associated with death due to cancer ( P = .003, P = .002, P = .030, and P = .002, respectively). Conclusion The need to take ≥2 margins to achieve resection portends an increased risk of locoregional recurrence and death due to disease in oropharyngeal SCC.