Transoral robotic surgery in patients with stage III/IV hypopharyngeal squamous cell carcinoma: treatment outcome and prognostic factor

Acta Otolaryngol. 2019 Sep;139(9):816-822. doi: 10.1080/00016489.2019.1631480. Epub 2019 Jul 3.

Abstract

Background: We aimed to reduce the morbidity related to treatment and to preserve organ function in patients with hypopharyngeal squamous cell carcinoma (HPSCC) by applying a new surgical treatment protocol based on transoral robotic surgery (TORS). Aims/objectives: In this study, we analyzed the prognostic factors related to survival to confirm the validity and effectiveness of TORS in patients with advanced-stage HPSCC. Methods: We retrospectively analyzed the data of 44 HPSCC patients who had undergone TORS-based therapy. Results: In univariate analysis, only the surgical marginal status showed a statistically significant correlation with the survival of the patients (p = .009). In multivariate analysis, surgical margin status was the only statistically significant prognostic factor related to survival (p = .008). Forty-one patients (93.2%) recovered speech function sufficiently to perform daily conversation without artificial aids. Forty-one patients (93.2%) were able to ingest food orally. Conclusions: In the treatment of advanced hypopharyngeal cancer, TORS-based therapy helped the surgeon obtain a clear surgical margin in patients with HPSCC, and it showed superior oncologic and functional outcomes compared to the existing treatment methods.

Keywords: Transoral robotic surgery; advanced stage; hypopharyngeal cancer; margin status; organ-preserving surgical treatment.

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Cohort Studies
  • Disease-Free Survival
  • Female
  • Humans
  • Hypopharyngeal Neoplasms / drug therapy
  • Hypopharyngeal Neoplasms / mortality*
  • Hypopharyngeal Neoplasms / pathology
  • Hypopharyngeal Neoplasms / surgery*
  • Male
  • Margins of Excision
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Minimally Invasive Surgical Procedures / mortality
  • Mouth
  • Natural Orifice Endoscopic Surgery / methods*
  • Neoadjuvant Therapy
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Predictive Value of Tests
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Robotic Surgical Procedures / methods*
  • Squamous Cell Carcinoma of Head and Neck / drug therapy
  • Squamous Cell Carcinoma of Head and Neck / mortality*
  • Squamous Cell Carcinoma of Head and Neck / pathology
  • Squamous Cell Carcinoma of Head and Neck / surgery*
  • Survival Analysis