Abstract
ObjectiveWe investigated the quality of life (QoL), functional, and oncological outcomes after robotic-assisted transoral or combined cervical-transoral salvage surgery for oropharyngeal carcinoma following radiotherapy. Material and methodsWe performed a single tertiary referral center, prospective, observational cohort study of all consecutive patients who underwent salvage robotic-assisted surgery for oropharyngeal carcinoma between 2015 and 2021. The primary outcomes were quality of life assessments using the MDADI, EORTC-QLQC30, and EORTC-QLQH&N35. Secondary endpoints were the functional and oncological outcomes based on overall survival, disease-free survival, and local control. ResultsA consecutive cohort of 53 patients were included. The median Charlson comorbidity index was 5. The p16 status was negative in 87%, and 22.6% were T3-4. A flap reconstruction was performed in 90.6%, with a free flap in 67.9%. Margins were negative in 81.1%. The preoperative, 1-year, and 2-year MDADI total scores were 71.4, 64.3, and 57.5, respectively. The preoperative, 1-year, and 2-year QLQ-C30 global scores were 61.2, 59.4, and 80.6, respectively. Decannulation was possible in 97.1% of the tracheotomized patients. The two-year enteral tube dependence was 23.1%. The two-year overall survival, disease-free survival, and local control rates were 59%, 46.1%, and 80.9%, respectively. ConclusionRobotic-assisted salvage surgery for oropharyngeal carcinoma following radiotherapy demonstrated a very satisfactory quality of life, good functional sequelae, and good oncological outcomes compared to historical approaches.
Highlights
Oropharyngeal carcinoma (OPC) occurring in a previously radiated field (ReRuNeR) comprises residual tumors that remained after radiation, recurrence of the tumor at the same site after a disease-free interval, and a new primary arising in a previously irradiated field [1]
Since 2015, we have performed robotic-assisted oropharyngeal surgery following radiotherapy via either a transoral or a cervical-transoral approach for patients not requiring a mandibulectomy as an alternative to open procedures, as this is thought to preserve quality of life
With a tracheostomy, or with free flaps were monitored in the intensive care unit for 24, 48, or 72 h, respectively
Summary
We investigated the quality of life (QoL), functional, and oncological outcomes after roboticassisted transoral or combined cervical-transoral salvage surgery for oropharyngeal carcinoma following radiotherapy. Material and methods: We performed a single tertiary referral center, prospective, observational cohort study of all consecutive patients who underwent salvage robotic-assisted surgery for oropharyngeal carcinoma between 2015 and 2021. Secondary endpoints were the functional and oncological outcomes based on overall survival, disease-free survival, and local control. The p16 status was negative in 87%, and 22.6% were T3-4. The two-year overall survival, disease-free survival, and local control rates were 59%, 46.1%, and 80.9%, respectively. Conclusion: Robotic-assisted salvage surgery for oropharyngeal carcinoma following radiotherapy demonstrated a very satisfactory quality of life, good functional sequelae, and good oncological outcomes compared to historical approaches
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