Transoral Robotic Surgery versus External Approach: Oncologic Results and Comparison of the Cost of Treatment

Abstract

Objectives: Compare functional outcomes, oncologic outcomes and treatment costs between a group of consecutive patients operated by transoral robotic surgery (TORS) for squamous cell carcinoma of the upper aero-digestive tract (UADT) and a matched group of patients operated by CC. Methods: 21 patients who underwent TORS from December 18, 2008 to January 21, 2012, were matched on age, sex, TNM stage, tumor location, type of neck dissection realized and operator with 21 patients operated by CC from July 19, 2005 to May 22, 2008 (before the arrival of the robot in our center). Results: In each group there were 3 T1 tumors, 16 T2 and 2 T3. The number of tracheotomy was significantly lower in the TORS group (3 vs18, respectively 14 and 86%, P < 0.001). The average length of feeding by NT and hospitalization were shorter in the TORS group (respectively, 9 vs 16 days, P = 0.01 and 11 vs 19 days, P = 0.001). There was no significant difference in the rate of recurrence-free survival at 3 years between the 2 groups (89% for the TORS group and 85% in the CC group, P = 0.76). The average treatment cost was reduced by 5488 euros for the TORS group ( P = 0.03). Conclusions: Robotic technology allows the treatment of T1-T2-T3 selected squamous cell carcinoma of the UADT, reducing morbidity and treatment costs while providing an equivalent cancer control at 3 years. Prospective and longitudinal studies could confirm these encouraging results.