Transoral robotic resection and reconstruction for head and neck cancer

作者：Eric Michael Genden, Tamar A. Kotz, Charles C. L. Tong, Claris Smith, Andrew Gregory Sikora, Marita S. Teng, Stuart H. Packer, William L. Lawson, Johnny Kao · 发表于：The Laryngoscope · 年份：2011 · DOI：10.1002/lary.21845 · 被引用次数：163 · 研究领域：Head and Neck Cancer Studies、Head and Neck Surgical Oncology、Reconstructive Surgery and Microvascular Techniques

OBJECTIVES/HYPOTHESIS: To evaluate the patterns of failure, survival, and functional outcomes for patients treated with transoral robotic surgery (TORS) and compare these results with those from a cohort of patients treated with concurrent chemoradiation (CRT). STUDY DESIGN: Prospective non-randomized case control study. METHODS: Between April 2007 and April 2009, 30 patients with head and neck squamous cell carcinoma were treated with primary TORS and adjuvant therapy as indicated on an institutional review board-approved protocol. Patients were evaluated before treatment, after treatment, and at subsequent 3-month intervals after completing treatment to determine their disease and head and neck-specific functional status using the Performance Status Scale for Head and Neck Cancer and the Functional Oral Intake Score (FOIS). Functional scores were compared to a matched group of head and neck patients treated with primary CRT. RESULTS: The TORS patient population included 73% stage III-IV and 23% nonsmokers. The median follow-up was 20.4 months (range, 12.8-39.6 months). The 18-month locoregional control, distant control, disease-free survival, and overall survival were 91%, 93%, 78%, and 90%, respectively. Compared to the primary CRT group, TORS was associated with better short-term eating ability (72 vs. 43, P = .008), diet (43 vs. 25, P = .01), and FOIS (5.5 vs. 3.3, P < .001) at 2 weeks after completion of treatment. In contrast to TORS patients who returned to baseline, ...