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Decreased gastrostomy tube incidence and weight loss after transoral robotic surgery for low‐ to intermediate‐risk oropharyngeal squamous cell carcinoma
Author(s) -
Heah Harold,
Goepfert Ryan P.,
Hutcheson Katherine A.,
Garden Adam S.,
Gunn G. Brandon,
Fuller Clifton D.,
Lewin Jan S.,
Kupferman Michael E.,
Holsinger F. Christopher,
Hessel Amy C.,
Gross Neil D.
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.25382
Subject(s) - transoral robotic surgery , medicine , gastrostomy tube , gastrostomy , common terminology criteria for adverse events , incidence (geometry) , feeding tube , surgery , weight loss , basal cell , adverse effect , multivariate analysis , retrospective cohort study , radiation therapy , physics , optics , obesity
Background Functional outcomes after treatment for oropharyngeal squamous cell carcinoma (SCC) are increasingly prioritized. The purpose of this study was to investigate the incidence of gastrostomy tube placement and weight loss in patients with oropharyngeal SCC who may be eligible for either transoral robotic surgery (TORS) or nonsurgical management. Methods We conducted a retrospective review of previously untreated T1 to T2 and N0 to N2b oropharyngeal SCC to determine the rates of gastrostomy tube placement and weight loss according to Common Terminology Criteria for Adverse Events (CTCAE) criteria. Multivariate regression models were fit to compare these end points between groups. Results Two hundred twenty‐three patients were included, comprised of 66 patients who underwent TORS and 157 patients who underwent (chemo)radiation. Thirty‐two (48.5%) of the TORS patients received adjuvant radiation. On multivariate analysis, patients treated nonsurgically were 10.6 times and 8.1 times more likely to receive a gastrostomy tube and experience greater than CTCAE grade 1 weight loss, respectively. Conclusion In selected patients with oropharyngeal SCC, TORS may help avoid critical weight loss and gastrostomy tube placement in the acute treatment period.