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Robotic transoral approach for salvage retropharyngeal node dissection: an analysis of functional and oncological
Surender K Dabas1, Yash Chaddha1, Ashwani Sharma1
1Department of Surgical Oncology and Robotic Surgery, BLK Hospital, Pusa Road, Radha Soami Satsang Marg, Rajendra Place, New Delhi, 110005, India.
Abstract:
Presence of metastatic tumour in the retropharyngeal node has a negative impact on the prognosis. We present here our 5-year experience and the outcomes of transoral robotic retropharyngeal node dissection (RPND) in salvage settings. Hospital database was accessed to extract details of patients with head and neck cancer who developed retropharyngeal (RP) node metastasis. Patients who underwent transoral robotic surgery (TORS) for RPND in salvage settings were included for the study. Patients were first followed-up after 10 days of discharge and then on a monthly basis after completion of treatment. At each follow-up, swallow functions and disease status were recorded. A total of 10 patients met the inclusion criteria and underwent salvage transoral robotic RPND. The total number of lymph nodes removed from these patients were 11, with all having malignant tumour deposits. The median follow-up was 20 months. Four patients developed distant metastasis. There were no major procedure-related complications. Our experience suggests that TORS as treatment modality is oncologically sound and feasible for salvage RP node dissection.Level of evidence Retrospective Study (3).
Insights
Transoral robotic retropharyngeal node dissection (RPND) is a feasible and oncologically sound option for head and neck cancer patients with metastatic retropharyngeal nodes. This salvage surgery showed no major complications in a 5-year study.
Area of Science:
- Surgical Oncology
- Head and Neck Surgery
- Robotic Surgery
Background:
- Metastatic retropharyngeal (RP) lymph nodes in head and neck cancer negatively impact patient prognosis.
- Salvage surgery for recurrent or persistent RP node metastasis is challenging.
- Transoral robotic surgery (TORS) offers a minimally invasive approach for head and neck procedures.
Purpose of the Study:
- To evaluate the outcomes and feasibility of transoral robotic retropharyngeal node dissection (RPND) in salvage settings.
- To assess the oncological soundness and safety of TORS for RPND in head and neck cancer patients.
Main Methods:
- Retrospective review of a hospital database for head and neck cancer patients with RP node metastasis.
- Inclusion of patients who underwent salvage transoral robotic surgery (TORS) for RPND.
- Follow-up included assessment of swallow function and disease status post-treatment.
Main Results:
- Ten patients underwent salvage transoral robotic RPND, with a median follow-up of 20 months.
- A total of 11 lymph nodes were removed, all containing malignant tumor deposits.
- No major procedure-related complications were observed; four patients developed distant metastasis.
Conclusions:
- Transoral robotic surgery (TORS) is an oncologically sound and feasible treatment modality for salvage retropharyngeal node dissection (RPND).
- TORS provides a viable option for managing challenging cases of metastatic retropharyngeal nodes in head and neck cancer.
- Further research may explore long-term outcomes and patient-reported functional results.
