Due to the fact that conventional surgery is technically demanding and involves significant morbidity, transoral procedures are becoming increasingly popular. In this prospective study the authors analysed the oncological and functional results of transoral robotic surgery (TORS) to find out if it was suitable as a minimally invasive treatment for oropharyngeal cancer. Thirty-nine patients with oropharyngeal cancer were treated by TORS. The authors assessed overall and disease-free survival by the Kaplan-Meier test. They also used videopharyngography and the functional outcome swallowing scale (FOSS) to evaluate swallowing. They used nasometry to estimate hypernasality, and acoustic waveform analysis to evaluate the voice. Thirty-seven patients (95%) had histologically clear margins of resection. Overall survival at two years was 96% and disease-free survival 92%. An oral diet was tolerable after a mean of six (range one to 18) days. No serious swallowing difficulties were seen on the videopharyngogram. Thirty-six of 38 patients could swallow well (97%) with FOSS scores ranging from zero to two (one patient had a poor score but was able to take an oral diet after postural training). Voices were maintained close to the normal range on the acoustic waveform analysis. The authors conclude that TORS is a valid treatment for selected patients with oropharyngeal cancer and this led to shorter hospital stays with more rapid functional recoveries of swallowing and decannulation.
Outcomes of transoral robotic surgery for oropharyngeal cancer
Reviewed by Sampath Chandra Prasad
Oncological and functional outcomes of transoral robotic surgery for oropharyngeal cancer.
