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Cited 22 time in webofscience Cited 24 time in scopus
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Transoral robotic surgery-based therapy in patients with stage III-IV oropharyngeal squamous cell carcinoma

Authors
Park, Young MinKim, Hye RyunCho, Byoung ChulKeum, Ki ChangCho, Nam HoonKim, Se-Heon
Issue Date
Dec-2017
Publisher
ELSEVIER SCIENCE BV
Keywords
Oropharyngeal cancer; Transoral robotic surgery; Adjuvant therapy; Neoadjuvant chemotherapy
Citation
ORAL ONCOLOGY, v.75, pp 16 - 21
Pages
6
Indexed
SCI
SCIE
SCOPUS
Journal Title
ORAL ONCOLOGY
Volume
75
Start Page
16
End Page
21
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/34140
DOI
10.1016/j.oraloncology.2017.10.014
ISSN
1368-8375
1879-0593
Abstract
Objective: TORS-based therapy including chemotherapy or RTx was administered to patients with stage III-IV OPSCC. We analyzed the oncological and functional outcomes of stage III-IV OPSCC patients who underwent TORS-based therapy. Materials and methods: Between May 2008 and May 2016, 80 patients participated in this clinical trial. Results: A negative margin was identified in 66 patients (82.5%) and a positive margin in 14 (17.5%). TNM stages were III in 13 patients (16.3%) and IV in 67 patients (83.8%). Of the patients, 13 received surgery alone, 28 had adjuvant RTx and 39 had adjuvant CCRTx. At last follow-up, 67 patients had no evidence of disease, seven were alive with disease, and six had died. Local recurrence developed in 2 patients and regional recurrence in 10. Five-year overall survival was 88.8%, disease-specific survival was 89.9%, and recurrence-free survival was 78.3%. The 5-year disease-specific survival of OPSCC patients with p16+ disease was 93.2%, which was higher than 89.0% of patients with p16-disease, but the difference was not statically significant. On multivariate analysis, only extranodal extension showed a significant relationship with recurrence-free survival on Cox regression analysis. Conclusion: TORS-based therapy showed excellent oncological and functional outcomes for treatment of stage III-IV OPSCC. For advanced T stage OPSCC, clear margins were obtained using TORS-based therapy and patients with clear margins showed good local control. Risk stratification of patients based on pathological information obtained after surgery and decision about additional treatment based on the information helped improve OS and DSS of OPSCC patients.
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