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Oncologic Outcomes After Transoral Robotic Surgery: A Multi-institutional Study
John R de Almeida1, Ryan Li2, J Scott Magnuson3
1Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Center, Toronto, Ontario, Canada.
JAMA Otolaryngology-- Head & Neck Surgery
|September 25, 2015
Summary
Transoral robotic surgery (TORS) demonstrates favorable oncologic outcomes for head and neck cancers, particularly oropharyngeal cancer, in a large multi-institutional study. This validates TORS as a key component of cancer treatment.
Area of Science:
- Oncology
- Surgical Oncology
- Robotic Surgery
Background:
- Transoral robotic surgery (TORS) is an evolving technique for head and neck cancer management.
- Large-scale, multi-institutional data are crucial for validating its efficacy and understanding outcomes.
Purpose of the Study:
- To review oncologic outcomes of TORS from a large multi-institutional collaboration.
- To identify predictors of disease recurrence and disease-specific mortality in patients treated with TORS.
Main Methods:
- Retrospective review of 410 patients undergoing TORS for laryngeal and pharyngeal cancers (2007-2012) across 11 institutions.
- Survival analysis (Kaplan-Meier, Cox regression) to assess locoregional control, disease-specific survival, and overall survival.
- Identification of independent predictors for oncologic outcomes.
Main Results:
- The 2-year locoregional control rate was 91.8%, disease-specific survival was 94.5%, and overall survival was 91%.
- Multivariate analysis indicated improved survival for women and patients with tonsil tumors; smoking was linked to worse overall mortality.
- While advanced age, tobacco use, and tumor stage showed associations, they did not remain significant independent predictors in multivariate analysis.
Conclusions:
- This multi-institutional study supports TORS as a valuable component of the multidisciplinary treatment for head and neck cancers, especially oropharyngeal cancer.
- Favorable oncologic outcomes were observed consistently across participating institutions.
- Further evaluation through National Cancer Institute-funded clinical trials will continue to define the role of robotic surgery in head and neck oncology.
