Transoral Robotic Surgery and Geriatric Population: Which Benefit?

Abstract

1.1. Purpose: As a result of increased life expectancy, the proportion of elderly patients with head and neck cancer is constantly rising. Transoral robotic surgery has been developed over the last ten years as a minimal invasive surgical procedure. The purpose of this study is to evaluate the place of this technique for elderly patients. 1.2. Methods & material: Study data related to elderly (age over 75 years) patients who underwent TORS between March 2008 and March 2018 were analyzed. 28 elderly patients were included; the different locations were 18 laryngeal (10 glottic and 8 supraglottic), 3 hypopharyngeal, 2 oral cavities and 5 oropharyngeal carcinoma respectively. 1.3. Results: 28 patients, 23 men and 5 women, with an average of 79 years old were successfully operated without external conversion. The 3-year Disease-Specific Survival (DSS) rate is 87.3% and the 3-year overall survival (OS) rate is 65,6%. Surgery was completed in a mean of 131 minutes (including exposure). All patients were extubated the same day (56%) or the day after the surgery (44%). Except for total laryngectomies, three patients (10.7%) received transient tracheostomies. Oral feeding was started after an average of 11 days after surgery. The hospitalization stay was 27 days on average. 1.4. Conclusions: Trans-oral Robotic surgery is a valuable technical option to address selected head and neck carcinoma in the elderly population. Early postoperative rehabilitation limits swallowing disorders and pulmonary complications. The surgical time is reduced compared to conventional open surgery which is a great advantage for this fragile population.