Transoral Resection Technique and Resected Tissue Volume in Patients with Oropharyngeal Squamous Cell Carcinoma

Abstract

Objectives: Elucidate the relationship between transoral resection technique and resected tissue volume in patients with early stage oropharyngeal squamous cell cancer (OPSCC) and determine if resection volume affects functional outcome. Methods: Forty-six patients with previously untreated early T-stage OPSCC underwent transoral laser microsurgery (TLMS) and transoral robotic surgery (TORS) between 2008 and 2013 at academic referral center were studied retrospectively. The resected tissue volume, the location of resection, and MD Anderson Dysphagia Inventory (MDADI) were described. Results: Mean resected tissue volume for T1 tumors with TORS was 11.44 cm3 and was 7.90 cm3 with TLMS, ( P = 0.44). Mean resected tissue volume for T2 tumors with TORS was 19.45 cm3 and 10.73 cm3 for TLMS ( P = 0.194). With a median follow-up of 11 months, the average of MDADI score was 77.9 for TORS and 74.2 for TLMS for T1 tumors, ( P = 1) and 67.9 for TORS and 50.1 for TLMS, ( P = 0.052) for T2 tumors. MDADI score for T1 with TLMS and TORS combined was 76.7 and for T2 was 63.45 ( P = 0.0048). Conclusions: TLMS and TORS are minimally invasive surgical approaches used to treat OPSCC. Both techniques employ different resection techniques; TLMS removes smaller, tumor specific volumes while TORS has anatomy-based predefined resection limits. Our study shows that despite these differences in surgical technique, there is no statistical difference in resected tissue volumes and swallowing function for T1 and T2 tumors removed by both techniques. However, functional outcome of both techniques combined for T1 tumors were superior to T2 tumors.