Long-term Functional and Quality-of-Life Outcomes After Transoral Robotic Surgery in Patients With Oropharyngeal Cancer

作者：Virginie Achim, Rachel K. Bolognone, Andrew D. Palmer, Donna J. Graville, Tyler J. Light, Ryan Li, Neil D. Gross, Peter E. Andersen, Daniel R. Clayburgh · 发表于：JAMA Otolaryngology–Head & Neck Surgery · 年份：2017 · DOI：10.1001/jamaoto.2017.1790 · 被引用次数：91 · 研究领域：Head and Neck Cancer Studies、Dysphagia Assessment and Management、Voice and Speech Disorders

IMPORTANCE: In recent years, transoral robotic surgery (TORS) has emerged as a useful treatment for oropharyngeal squamous cell carcinoma (OPSCC). In appropriately selected patients, the use of TORS may allow avoidance of adjuvant chemotherapy and/or radiotherapy, thereby avoiding the long-term adverse effects of these therapies. OBJECTIVE: To compare functional speech, swallowing, and quality-of-life outcomes longitudinally between those undergoing TORS only and those undergoing TORS and adjuvant radiotherapy (TORS+RT) or TORS and chemoradiotherapy (TORS+CRT). DESIGN, SETTING, AND PARTICIPANTS: This prospective, longitudinal cohort study performed from June 1, 2013, through November 31, 2015, included 74 patients undergoing TORS for initial treatment of OPSCC at a single tertiary academic hospital. MAIN OUTCOMES AND MEASURES: Data were collected at baseline, postoperatively (7-21 days), at short-term follow-up (6-12 months), and at long-term follow-up (>12 months). The quality-of-life metrics included the 10-item Eating Assessment Tool and the University of Michigan Head and Neck Quality of Life instrument. Data were also collected on tumor staging, surgical and adjuvant therapy details, patient comorbidities, tracheostomy and feeding tube use, and functional speech and swallowing status using the Performance Status Scale for Head and Neck Cancer Patients. RESULTS: Seventy-four patients were enrolled in the study (mean [SD] age, 61.39 [7.99] years; 68 [92%] male). Median lon...