Mini-invasive lateral oropharyngectomy for T3-T4a oropharyngeal cancer

Eur Arch Otorhinolaryngol. 2013 Mar;270(4):1419-25. doi: 10.1007/s00405-012-2158-5. Epub 2012 Aug 26.

Abstract

Mandibular swing is the approach of choice for resection of advanced oropharyngeal carcinomas without bone involvement. This approach requires a mandibulotomy, which is associated with complications. A prospective outcome analysis was performed for 21 patients operated without mandibulotomy for T3-T4a oropharyngeal carcinoma. Tumour size was categorized as T3 in 14 patients (66.7 %) and as T4a (33.3 %) in 7 patients. Twelve patients were N0 (57.1 %), 2 (9.5 %) were N1, and 7 (33.3 %) were N2. Surgical margins were negative in 18 cases (85.7 %), positive in 1 (4.8 %), and close in 2 (9.5 %). Average hospital stay was 14.5 days (range 10-22). Adjuvant treatment (radiotherapy or concurrent chemoradiotherapy) was administered to all but three patients previously irradiated. In all cases radiotherapy started within 42 days of surgery. The 3-year overall survival was 85.7 %, and relapse-free survival was 71.4 %. Oropharyngectomy without mandibulotomy has the same indications as mandibular swing. It provides good access to achieve satisfactory clearance of tumours, sparing patients the morbidity associated with mandibulotomy.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / drug therapy
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / radiotherapy
  • Carcinoma, Squamous Cell / surgery*
  • Chemoradiotherapy
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Length of Stay
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods*
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Neoplasm, Residual / pathology
  • Neoplasm, Residual / surgery
  • Oropharyngeal Neoplasms / drug therapy
  • Oropharyngeal Neoplasms / pathology
  • Oropharyngeal Neoplasms / radiotherapy
  • Oropharyngeal Neoplasms / surgery*
  • Oropharynx / pathology
  • Oropharynx / surgery*
  • Postoperative Complications / diagnosis
  • Prospective Studies
  • Radiotherapy, Adjuvant
  • Surgical Flaps