1
|
Cleere EF, Read C, Prunty S, Duggan E, O'Rourke J, Moore M, Vasquez P, Young O, Subramaniam T, Skinner L, Moran T, O'Duffy F, Hennessy A, Dias A, Sheahan P, Fitzgerald CWR, Kinsella J, Lennon P, Timon CVI, Woods RSR, Shine N, Curley GF, O'Neill JP. Airway decision making in major head and neck surgery: Irish multicenter, multidisciplinary recommendations. Head Neck 2024; 46:2363-2374. [PMID: 38984517 DOI: 10.1002/hed.27868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 06/21/2024] [Accepted: 06/30/2024] [Indexed: 07/11/2024] Open
Abstract
Major head and neck surgery poses a threat to perioperative airway patency. Adverse airway events are associated with significant morbidity, potentially leading to hypoxic brain injury and even death. Following a review of the literature, recommendations regarding airway management in head and neck surgery were developed with multicenter, multidisciplinary agreement among all Irish head and neck units. Immediate extubation is appropriate in many cases where there is a low risk of adverse airway events. Where a prolonged definitive airway is required, elective tracheostomy provides increased airway security postoperatively while delayed extubation may be appropriate in select cases to reduce postoperative morbidity. Local institutional protocols should be developed to care for a tracheostomy once inserted. We provide guidance on decision making surrounding airway management at time of head and neck surgery. All decisions should be agreed between the operating, anesthetic, and critical care teams.
Collapse
Affiliation(s)
- Eoin F Cleere
- Department of Otolaryngology - Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland
| | - Christopher Read
- Department of Anaesthesia and Critical Care, Beaumont Hospital, Dublin, Ireland
| | - Sarah Prunty
- Department of Otolaryngology - Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland
| | - Edel Duggan
- Department of Anaesthesia and Critical Care, Beaumont Hospital, Dublin, Ireland
| | - James O'Rourke
- Department of Anaesthesia and Critical Care, Beaumont Hospital, Dublin, Ireland
| | - Michael Moore
- Department of Anaesthesia and Critical Care, Beaumont Hospital, Dublin, Ireland
| | - Pedro Vasquez
- Department of Physiotherapy, Beaumont Hospital, Dublin, Ireland
| | - Orla Young
- Department of Otolaryngology - Head and Neck Surgery, Galway University Hospital, Galway, Ireland
| | - Thavakumar Subramaniam
- Department of Otolaryngology - Head and Neck Surgery, Galway University Hospital, Galway, Ireland
| | - Liam Skinner
- Department of Otolaryngology - Head and Neck Surgery, University Hospital Waterford, Waterford, Ireland
| | - Tom Moran
- Department of Otolaryngology - Head and Neck Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
- Department of Otolaryngology - Head and Neck Surgery, St Vincent's University Hospital, Dublin, Ireland
| | - Fergal O'Duffy
- Department of Otolaryngology - Head and Neck Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
- Department of Otolaryngology - Head and Neck Surgery, St Vincent's University Hospital, Dublin, Ireland
| | - Anthony Hennessy
- Department of Anaesthesiology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - Andrew Dias
- Department of Otolaryngology - Head and Neck Surgery, South Infirmary Victoria University Hospital, Cork, Ireland
| | - Patrick Sheahan
- Department of Otolaryngology - Head and Neck Surgery, South Infirmary Victoria University Hospital, Cork, Ireland
- ENTO Research Unit, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Conall W R Fitzgerald
- Department of Otolaryngology - Head and Neck Surgery, St James's Hospital, Dublin, Ireland
| | - John Kinsella
- Department of Otolaryngology - Head and Neck Surgery, St James's Hospital, Dublin, Ireland
| | - Paul Lennon
- Department of Otolaryngology - Head and Neck Surgery, St James's Hospital, Dublin, Ireland
| | - Conrad V I Timon
- Department of Otolaryngology - Head and Neck Surgery, St James's Hospital, Dublin, Ireland
| | - Robbie S R Woods
- Department of Otolaryngology - Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland
| | - Neville Shine
- Department of Otolaryngology - Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland
| | - Gerard F Curley
- Department of Anaesthesia and Critical Care, Beaumont Hospital, Dublin, Ireland
- Department of Anaesthesia and Critical Care, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - James P O'Neill
- Department of Otolaryngology - Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland
- Department of Otolaryngology - Head and Neck Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland
| |
Collapse
|
2
|
Müderris T, Sevil E, Gül F. Transoral robotic supraglottic laryngectomy: Long-term functional and oncologic outcomes. Am J Otolaryngol 2024; 45:104105. [PMID: 37977058 DOI: 10.1016/j.amjoto.2023.104105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 10/17/2023] [Accepted: 10/29/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVES Minimally invasive transoral organ preservation surgeries are being increasingly used for supraglottic tumors. This study investigates the long-term functional and oncologic outcomes of transoral robotic supraglottic laryngectomy (TORS-SGL). MATERIALS AND METHODS Twenty-three patients with supraglottic laryngeal cancer who underwent TORS-SGL between 2012 and 2015 at a tertiary referral hospital were retrospectively analyzed with at least 5 years of follow-up. The head and neck tumor council and the multidisciplinary oncological board decided whether the patients were suitable for robotic surgery, and the necessity of adjuvant radiotherapy or chemotherapy. Inclusion criteria was histopathological diagnosis of squamous cell carcinoma of the larynx. RESULTS Twenty-one patients with T1-T3 supraglottic squamous cell carcinoma were included in this study. Mean follow-up was 48.8 months. Local control was 94.4 % at 2 years and 85.9 % at 5 years. Disease-free survival and overall survival were 85.7 % and 81 % at 2 years and 69.3 % and 57.1 % at 5 years, respectively. There was no permanent tracheostomy or prolonged swallowing dysfunction among patients. Age, perineural and lymphovascular invasion were found to be risk factors affecting overall survival. CONCLUSION TORS-SGL is a feasible, safe and reliable approach with excellent functional results for T1, T2, and selected T3 supraglottic tumors, providing acceptable long-term oncologic results when compared to alternative treatment modalities.
Collapse
Affiliation(s)
- Togay Müderris
- Izmir Bakırçay University Faculty of Medicine, Department of Otorhinolaryngology, Head and Neck Surgery, Izmir, Turkey.
| | - Ergün Sevil
- Alaaddin Keykubat University Faculty of Medicine, Department of Otorhinolaryngology, Head and Neck Surgery, Antalya, Turkey
| | - Fatih Gül
- Ankara Yıldırım Beyazıt University Faculty of Medicine, Department of Otorhinolaryngology, Head and Neck Surgery, Ankara, Turkey
| |
Collapse
|
3
|
Hassid S, Krug B, Deheneffe S, Daisne JF, Delahaut G, Lawson G, Crott R, Van der Vorst S. Treatment of supraglottic squamous cell carcinoma with advanced technologies: observational prospective evaluation of oncological outcomes, functional outcomes, quality of life and cost-effectiveness (SUPRA-QoL). BMC Cancer 2023; 23:493. [PMID: 37264321 DOI: 10.1186/s12885-023-10953-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 05/11/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Over the past decade, therapeutic options in head and neck supraglottic squamous cell carcinoma have constantly evolved. The classical total laryngectomy has been partially replaced by alternative organ- and function-sparing techniques with the same prognosis but less morbidity, such as Radiotherapy, Transoral Laser Microsurgery (TLM) and Trans-Oral Robotic Surgery (TORS). Up to now, a prospective comparison of these innovant techniques has not been conducted. METHODS/DESIGN We will conduct an original international multicentric prospective nonrandomized clinical trial to compare the efficacy between these treatments (Arm 1: Radiotherapy ± chemotherapy; Arm 2: TLM and Arm 3: TORS) with 4 classes of outcomes: quality of life (QoL), oncological outcomes, functional outcomes and economic resources. The population will include cT1-T2 /cN0-N1/M0 supraglottic squamous cell carcinoma. The primary outcome is a Clinical Dysphagia QoL evaluation assessed by the MD Anderson Dysphagia questionnaire. Secondary outcomes include others QoL evaluation, oncological and functional measures and cost parameters. The sample size needs to reach 36 patients per arm (total 108). DISCUSSION In the current literature, no prospective head-to-head trials are available to compare objectively these different treatments. With the increase of highly efficient treatments and the increase of oncological survival, it is imperative also to develop management strategies that optimize QoL and functional results. We will conduct this innovate prospective trial in order to obtain objective data in these two main issues. TRIAL REGISTRATION NCT05611515 posted on 10/11/2022 (clinicaltrial.fgov).
Collapse
Affiliation(s)
- S Hassid
- Department of Otorhinolaryngology, UCLouvain, CHU UCL Namur (Site Godinne), Head & Neck Surgery, Yvoir, Belgium.
| | - B Krug
- Department of Nuclear Medicine, UCLouvain, CHU UCL Namur (Site Godinne), Yvoir, Belgium
| | - S Deheneffe
- Department of Radiotherapy, UCLouvain, CHU UCL Namur (Site St-Elisabeth), Namur, Belgium
| | - J-F Daisne
- Department of Radiation-Oncology, Catholic University of Leuven (KU Leuven), University Hospital UZ Leuven, Louvain, Belgium
- Leuvens Kankerinstituut, Louvain, Belgium
| | - G Delahaut
- Department of Otorhinolaryngology, UCLouvain, CHU UCL Namur (Site Godinne), Head & Neck Surgery, Yvoir, Belgium
| | - G Lawson
- Department of Otorhinolaryngology, UCLouvain, CHU UCL Namur (Site Godinne), Head & Neck Surgery, Yvoir, Belgium
| | - R Crott
- Health Economics Consultant, Formerly at Institute de Recherche Santé Et Société (IRSS)UCLouvain, Louvain, Belgium
| | - S Van der Vorst
- Department of Otorhinolaryngology, UCLouvain, CHU UCL Namur (Site Godinne), Head & Neck Surgery, Yvoir, Belgium
| |
Collapse
|
4
|
Papazian MR, Chow MS, Jacobson AS, Tran T, Persky MS, Persky MJ. Role of transoral robotic surgery in surgical treatment of early-stage supraglottic larynx carcinoma. Head Neck 2023; 45:972-982. [PMID: 36825894 DOI: 10.1002/hed.27325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 12/23/2022] [Accepted: 02/08/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND There are several options for primary surgical treatment of early-stage supraglottic squamous cell carcinoma (SCC), including transoral robotic surgery (TORS). The purpose of this study was to compare outcomes of TORS to open partial laryngectomy and transoral laser microsurgery (TLM). METHODS Patients with clinical classification T1-2 supraglottic SCC diagnosed 2010-2019, treated with TORS, open partial laryngectomy, or TLM in the National Cancer Database were selected. RESULTS One thousand six hundred three patients were included: 17% TORS, 26.5% TLM, 56.5% open. TORS patients had the lowest rates of adjuvant treatment (28.4% vs. TLM: 45.0%, open: 38.5%, p < 0.001), and lower positive margin rates than TLM (16.9% vs. 30.5%, p < 0.001). Thirty-day and ninety-day post-operative mortality did not differ between the approaches. Five-year survival was higher following TORS compared to open surgery (77.8% vs. 66.1%, p = 0.01); this difference persisted following matched-pair analysis. CONCLUSIONS TORS may be a safe and effective surgical approach for early-stage supraglottic SCC in appropriate patients.
Collapse
Affiliation(s)
| | - Michael S Chow
- Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York, USA
| | - Adam S Jacobson
- Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York, USA
| | - Theresa Tran
- Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York, USA
| | - Mark S Persky
- Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York, USA
| | - Michael J Persky
- Department of Otolaryngology-Head and Neck Surgery, NYU Langone Health, New York, New York, USA
| |
Collapse
|
5
|
Abstract
Although total laryngectomy continues to be important treatment of supraglottic laryngeal cancer, the management of early-stage disease has evolved from primary radiation/chemoradiation to consideration of partial laryngectomy surgery. Surgeon experience and careful patient selection can lead to excellent oncologic and functional outcomes for these techniques. However, advanced stage tumors and salvage situations are challenging and the ability to eradicate disease and preserve function should be carefully considered. Contraindications to supraglottic laryngectomy depend on surgical approach, as do complications. With adequate patient selection, high rates of cure and function can be achieved with both open and transoral supraglottic laryngectomy procedures.
Collapse
Affiliation(s)
- Rusha Patel
- Oklahoma University, 800 Stanton L Young Boulevard, Suite 1400, Oklahoma City, OK 73104, USA.
| |
Collapse
|
6
|
Chanda A, Krisciunas GP, Grillone GA. Correlating muscle resection with functional swallow outcomes: An anatomic framework informed systematic review of the literature. Am J Otolaryngol 2022; 43:103386. [PMID: 35158265 DOI: 10.1016/j.amjoto.2022.103386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 01/30/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To perform a systematic review of studies reporting swallow-associated outcomes in patients who received surgery for head and neck cancer (HNC), informed by an anatomic and physiologic framework of pharyngeal phase of swallowing (Pearson's dual-sling model). METHODS PUBMED and Google Scholar databases were searched for peer-reviewed papers published between 1990 and 2019 using relevant MeSH terms. Exclusion criteria were 1) discussions comparing reconstruction techniques, 2) case-report/series (n < 10), 3) perspective articles, 4) papers comparing objective instrumental methods of swallowing evaluation, 5) animal/cadaver studies, 6) no instrumental or validated swallow assessment tools used, 7) papers that discuss/include radiotherapy treatment, 8) systematic reviews, 9) papers that discuss swallow training or rehabilitation methods. Two investigators reviewed papers meeting inclusion/exclusions criteria. Muscles resected, anatomic resection site, swallow outcomes, and patient treatment variables were collected. RESULTS A total of 115,020 peer-reviewed papers were identified. 74 papers were relevant to this review, 18 met inclusion and exclusion criteria, and none discussed surgical impact on the pharyngeal phase of swallowing using Pearson's dual-sling model. Most papers discussed the effect of tongue-base, supraglottic, or regional anatomic resection. Post-surgical resection Follow-up times ranged from 1 to 13 months. 67% of studies used objective instrumental swallow studies; 22% used patient reported outcome measures. Follow up time since surgical resection, time to feeding tube removal, feeding tube present/absent, aspiration severity were used to define dysphagia endpoints. CONCLUSIONS To date, no surgical HNC studies have used the dual-sling mechanism to guide study design, and dysphagia assessment has been inconsistent. To counsel patients on the effects of surgery on pharyngeal phase of swallow function, specialists need physiologically grounded research that correlates muscles resected with consistent measures of swallow function.
Collapse
Affiliation(s)
- Anindita Chanda
- Touro College of Osteopathic Medicine, 60 Prospect Avenue, Middletown, NY 10940, United States.
| | - Gintas P Krisciunas
- Boston University School of Medicine, 72 E Concord St, Boston, MA 02118, United States.
| | - Gregory A Grillone
- Boston University School of Medicine, 72 E Concord St, Boston, MA 02118, United States.
| |
Collapse
|
7
|
Shankar R, Mishra A, Malik A. Role of Robotics in Non-oropharyngeal Head and Neck Tumours. Indian J Surg Oncol 2022; 13:436-442. [DOI: 10.1007/s13193-022-01526-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 02/21/2022] [Indexed: 10/19/2022] Open
|
8
|
Poissonnet V, Chabrillac E, Schultz P, Morinière S, Gorphe P, Baujat B, Garrel R, Lasne-Cardon A, Villeneuve A, Chambon G, Fakhry N, Aubry K, Dufour X, Malard O, Mastronicola R, Vairel B, Gallet P, Ceruse P, Jegoux F, Ton Van J, De Bonnecaze G, Vergez S. Airway management during transoral robotic surgery for head and neck cancers: a French GETTEC group survey. Eur Arch Otorhinolaryngol 2022; 279:3619-3627. [DOI: 10.1007/s00405-021-07188-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 11/15/2021] [Indexed: 11/03/2022]
|
9
|
Rao KN, Gangiti KK. Transoral Robotic Surgery. Indian J Surg Oncol 2021; 12:847-853. [PMID: 35110913 PMCID: PMC8764010 DOI: 10.1007/s13193-021-01443-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 09/01/2021] [Indexed: 11/21/2022] Open
Abstract
Transoral robotic surgery (TORS) became a valuable new head and neck surgery approach from the past decade since its approval. TORS was initially conceived for oropharyngeal squamous cell carcinoma (OPSCC); now, the indications are gradually extrapolated into other subsites. There have been numerous studies comparing the outcomes following surgical and non-surgical treatment, especially for oropharyngeal cancers. TORS for laryngeal cancers is in its infancy, and only a few reports are describing it. Many report suggestive of better functional outcomes following TORS, but level 1 evidence is still lacking. With the further development of novel, flexible, miniaturized robots, it is highly likely to expand TORS indications further. This article provides an overview of TORS in head and neck cancers.
Collapse
Affiliation(s)
- Karthik N. Rao
- Department of Head Neck Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Kranthi Kumar Gangiti
- Department of Head Neck Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| |
Collapse
|
10
|
Hans S, Chebib E, Chekkoury-Idrissi Y, Distinguin L, Circiu M, Vialatte de Pemille G, Julien-Laferriere A, Crevier-Buchman L, Lechien JR. Surgical and oncological outcomes of transoral robotic total laryngectomy: A case series. Oral Oncol 2021; 121:105511. [PMID: 34474271 DOI: 10.1016/j.oraloncology.2021.105511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 08/01/2021] [Accepted: 08/22/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To evaluate the oncological, functional and voice rehabilitation outcomes of transoral robotic surgery for total laryngectomy (TORS-TL). METHODS A retrospective chart review of patients treated by TORS-TL was conducted at a single academic medical center. The following outcomes were studied: indication; average robotic set-up and operative times; mean estimated blood loss; postoperative complications; re-feeding features; mean hospital stay; need of adjuvant therapy and voice rehabilitation type. RESULTS TORS-TL was performed in 10 patients for the following indications: nonfunctional larynx (N = 2); low-grade cricoid chondrosarcoma (N = 3) and recurrent laryngeal cancer after (chemo) radiation (N = 5). Two patients were excluded because the larynx was not exposable. Average robotic set-up and operative times were 20 and 278 min, respectively. The mean estimated blood loss was 50 mL. The mean hospital stay was 13.9 days (8-28 days). There was no local recurrence in patients operated for cancer recurrence (N = 5) 5 years after the surgery. Distant metastases occurred in one patient. A patient with laryngeal chondrosarcoma experienced local failure 3 years after TORS-TL. The voice rehabilitation consisted of esophageal voice (N = 2) and tracheoesophageal prosthesis (Provox®, N = 8). The main reasons for prosthesis replacement were transprosthetic (79%) and periprosthetic leaks (21%). The median lifespan of prostheses was 81 days. CONCLUSION TORS-TL may be a safe and effective surgical approach for selected surgical indications. Future controlled studies are needed to determine additional indications and limitations of this procedure.
Collapse
Affiliation(s)
- Stéphane Hans
- Robotic Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Emilien Chebib
- Robotic Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Younès Chekkoury-Idrissi
- Robotic Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Léa Distinguin
- Robotic Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Marta Circiu
- Robotic Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Grégoire Vialatte de Pemille
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Aude Julien-Laferriere
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Lise Crevier-Buchman
- Robotic Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Jérôme R Lechien
- Robotic Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.
| |
Collapse
|
11
|
Turner MT, Stokes WA, Stokes CM, Hassid S, Holsinger FC, Lawson G. Airway and bleeding complications of transoral robotic supraglottic laryngectomy (TORS-SGL): A systematic review and meta-analysis. Oral Oncol 2021; 118:105301. [PMID: 33940531 DOI: 10.1016/j.oraloncology.2021.105301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 04/06/2021] [Indexed: 01/21/2023]
Affiliation(s)
- Meghan T Turner
- Department of Otolaryngology-Head and Neck Surgery, West Virginia University Health Sciences Center, Morgantown, West Virginia, USA
| | - William A Stokes
- Department of Otolaryngology-Head and Neck Surgery, West Virginia University Health Sciences Center, Morgantown, West Virginia, USA.
| | - Cara M Stokes
- Department of Epidemiology, School of Public Health, West Virginia University Health Sciences Center, Morgantown, WV., USA
| | - Samantha Hassid
- Department of Otolaryngology-Head and Neck Surgery, Université Catholique de Louvain Centre Hospitalier Universitaire de Mont-Godinne, Yvoir, Belgium
| | - F Christopher Holsinger
- Division of Head and Neck Surgery, Department of Otolaryngology-Head and Neck Surgery, Stanford University Medical Center, Palo Alto, CA, USA
| | - Georges Lawson
- Department of Otolaryngology-Head and Neck Surgery, Université Catholique de Louvain Centre Hospitalier Universitaire de Mont-Godinne, Yvoir, Belgium
| |
Collapse
|
12
|
van der Kamp MF, van Dijk BAC, Plaat BEC, van der Laan BFAM, Halmos GB. To what extent has the last two decades seen significant progress in the management of older patients with head and neck cancer? Eur J Surg Oncol 2021; 47:1398-1405. [PMID: 33648773 DOI: 10.1016/j.ejso.2021.01.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 01/05/2021] [Accepted: 01/18/2021] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Life expectancy is rising and consequently also the number of older patients with head and neck cancer. Different treatment regimens are often applied for older patients. The aim of this study is to investigate how treatment patterns and survival rates have changed over the past 20 years in older patients with head and neck squamous cell carcinoma (HNSCC). MATERIALS Patient and tumour characteristics, treatment and 5-year survival data from the Netherlands Cancer Registry of patients aged ≥60 years diagnosed with HNSCC in 1990-1995 and 2010-2015 were compared using chi-square test and relative survival analysis. RESULTS Data of 14,114 patients were analyzed. Oral cavity cancer treatment did not change over time, while survival improved from 54% to 58% (p = 0.03). Oropharyngeal and hypopharyngeal cancer treatment shifted towards non-surgical, with survival improving from 31% to 51% (p < 0.01) and 26% to 34% (p < 0.01), respectively. Laryngeal cancer treatment changed towards surgery in stage I and non-surgical treatment in stage III and IV disease. Survival in laryngeal cancer stage I remained stable and favorable at a relative survival rate of around 90%. Survival non-significantly changed from 54% to 49% for stage III disease and from 37% to 33% for disease. CONCLUSION Relative survival increased for all head and neck cancer sites in older patients, except for laryngeal cancer. For oropharyngeal, hypopharyngeal and advanced laryngeal cancer, a shift towards non-surgical treatment modalities was observed.
Collapse
Affiliation(s)
- Martine F van der Kamp
- University of Groningen, University Medical Centre Groningen, Department of Otorhinolaryngology, Head & Neck Surgery, Groningen, the Netherlands.
| | - Boukje A C van Dijk
- Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands; University of Groningen, University Medical Centre Groningen, Department of Epidemiology, Groningen, the Netherlands
| | - Boudewijn E C Plaat
- University of Groningen, University Medical Centre Groningen, Department of Otorhinolaryngology, Head & Neck Surgery, Groningen, the Netherlands
| | - Bernard F A M van der Laan
- University of Groningen, University Medical Centre Groningen, Department of Otorhinolaryngology, Head & Neck Surgery, Groningen, the Netherlands
| | - Gyorgy B Halmos
- University of Groningen, University Medical Centre Groningen, Department of Otorhinolaryngology, Head & Neck Surgery, Groningen, the Netherlands
| |
Collapse
|
13
|
Hans S, Chekkoury-Idrissi Y, Circiu MP, Distinguin L, Crevier-Buchman L, Lechien JR. Surgical, Oncological, and Functional Outcomes of Transoral Robotic Supraglottic Laryngectomy. Laryngoscope 2020; 131:1060-1065. [PMID: 32812245 DOI: 10.1002/lary.28926] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 06/09/2020] [Accepted: 06/17/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVES/HYPOTHESIS To investigate the surgical, oncological, and functional outcomes of transoral robotic surgery (TORS) for the treatment of supraglottic squamous cell carcinoma. STUDY DESIGN Retrospective chart review. METHODS The charts of patients treated by TORS supraglottic laryngectomy (SGL) in an academic medical center were reviewed. The following outcomes were studied according to the tumor location: average robotic setup and operative times, mean estimated blood loss, postoperative complications, need of tracheotomy, refeeding characteristics, mean hospital stay, need of neck dissection and adjuvant therapy, 5-year local and regional controls, overall survival (OS), and disease-free survival (DFS). RESULTS Seventy-five patients underwent TORS SGL. Tumors were classified as cT1 (32%), cT2 (52%), and cT3 (16%). Average robotic setup and operative times and the mean estimated blood loss were 15 minutes, 55 minutes, and 20 mL, respectively. The mean follow-up period ranged from 2 to 5 years. The 5-year OS and DFS were 80.2% and 94.3%, respectively. Overall, 34.6% of patients received adjuvant radiotherapy. The majority of patients (92%) restarted an oral diet within 24 to 48 hours postsurgery. Transient tracheotomy was performed in 8% of patients. Postoperative hemorrhages occurred in 12 patients (16.0%), lengthening the hospital stay (mean = 6.8 days). There were no outcome differences regarding the tumor location. CONCLUSIONS TORS is an effective and safe therapeutic approach for early- and intermediate-stages cancers. Oncological outcomes may be quite similar to other surgical approaches, including transoral laser and open surgeries. Future randomized controlled studies are needed for comparing TORS SGL with other surgical procedures. LEVEL OF EVIDENCE 4 Laryngoscope, 131:1060-1065, 2021.
Collapse
Affiliation(s)
- Stéphane Hans
- Robotic Study Group of Young-Otolaryngologists of the International Federations of Otorhinolaryngological Societies (YO-IFOS), Paris, France.,Department of Otorhinolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Younès Chekkoury-Idrissi
- Robotic Study Group of Young-Otolaryngologists of the International Federations of Otorhinolaryngological Societies (YO-IFOS), Paris, France.,Department of Otorhinolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Marta P Circiu
- Robotic Study Group of Young-Otolaryngologists of the International Federations of Otorhinolaryngological Societies (YO-IFOS), Paris, France.,Department of Otorhinolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Léa Distinguin
- Robotic Study Group of Young-Otolaryngologists of the International Federations of Otorhinolaryngological Societies (YO-IFOS), Paris, France.,Department of Otorhinolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Lise Crevier-Buchman
- Robotic Study Group of Young-Otolaryngologists of the International Federations of Otorhinolaryngological Societies (YO-IFOS), Paris, France.,Department of Otorhinolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Jérôme R Lechien
- Robotic Study Group of Young-Otolaryngologists of the International Federations of Otorhinolaryngological Societies (YO-IFOS), Paris, France.,Department of Otorhinolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France.,Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons, Mons, Belgium
| |
Collapse
|
14
|
kalantari F, Rajaeih S, Daneshvar A, Karbasi Z, Mahdi Salem M. Robotic surgery of head and neck cancers, a narrative review. Eur J Transl Myol 2020; 30:8727. [PMID: 32782756 PMCID: PMC7385690 DOI: 10.4081/ejtm.2019.8727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 12/29/2019] [Indexed: 02/02/2023] Open
Abstract
Head and neck cancers are the most common cancers in the body. Treatments are determined on the basis of the location and stage of the primary tumor. The goal of treatment is to eliminate the tumor, prevent recurrence or metastasis, and maintain the quality of life. There are several treatments available for the management of head and neck cancers, including surgery, radiation therapy, chemotherapy, new molecular agents, and a combination of them. Transoral robotic technique is a short-time operation using a type of robotic machine in which the patient undergoes anesthesia for a shorter time and the side effects of this operation and the time of hospitalization are less than open surgery. Due to the importance of speed and accuracy in head and neck cancer surgery and the importance of application of robotics in surgery, the present study was designed and implemented to review the application of robotics in the management of head and neck cancers. In this review study, the keywords: application, robotic, surgical, head cancer, transoral robotic surgery (TORS), and neck cancer, were searched in ISI, PubMed, Scopus, Google scholar databases. Related articles written domestically or abroad that have covered areas such as the background of transoral robotic surgery, maintaining organ function and approaches, the advantages and disadvantages of TORS, the affordability of TORS, the combination of TORS with other therapeutic approaches published from 2003 to 2019 were reviewed. The use of robotic surgery for precise operations such as head and neck cancers seems to be essential. More advanced robotic devices are expected to expand the surgery treatment for head and neck cancers as well as the results of using TORS for oncologic optimization and acceptability of results while maintaining organ function and patient's quality of life.
Collapse
Affiliation(s)
- Farbood kalantari
- ENT and Head and Neck Research Center and Department, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran
- Skull Base Research Center, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Shahin Rajaeih
- ENT and Head and Neck Research Center and Department, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran
- Skull Base Research Center, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Daneshvar
- ENT and Head and Neck Research Center and Department, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran
- Skull Base Research Center, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Karbasi
- ENT and Head and Neck Research Center and Department, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran
- Skull Base Research Center, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mahdi Salem
- ENT and Head and Neck Research Center and Department, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran
- Skull Base Research Center, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
15
|
Lechien JR, Fakhry N, Saussez S, Chiesa-Estomba CM, Chekkoury-Idrissi Y, Cammaroto G, Melkane AE, Barillari MR, Crevier-Buchman L, Ayad T, Remacle M, Hans S. Surgical, clinical and functional outcomes of transoral robotic surgery for supraglottic laryngeal cancers: A systematic review. Oral Oncol 2020; 109:104848. [PMID: 32534362 DOI: 10.1016/j.oraloncology.2020.104848] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 05/30/2020] [Accepted: 06/03/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND The aim of this systematic review is to shed light the current indications and outcomes of transoral robotic surgery (TORS) supraglottic laryngectomy (SGL) in patients with supraglottic laryngeal cancer. METHODS PubMed, Scopus and Cochrane Library were searched by three independent otolaryngologists from the Young Otolaryngologists of IFOS for studies investigating the indications, effectiveness and safety of TORS SGL. Surgical, functional, and survival outcomes have been investigated. Inclusion/exclusion criteria; demographic data; and clinical outcome evaluation of papers were analyzed using PRISMA criteria. RESULTS A total of 14 papers met our inclusion criteria, accounting for 422 patients (335 males & 87 females). The tumor location mainly consisted of epiglottis (55.4%), aryepglottic fold (31.2%), and ventricular band (5.1%). The following tumor stages were considered: cT1 (35.8%); cT2 (48.6%) and cT3 (13.9%). Feeding tube and percutaneous endoscopic gastrostomy were used in 62.5% and 8.82% of patients, respectively. The 24-month local & regional control rates ranged from 94.3% to 100% and 87.5% to 94.0%, respectively. The 2-year and 5-year overall survival rates ranged from 66.7% to 88.0% and 78.7% to 80.2%, respectively. There was an important heterogeneity between studies with regard to the inclusion/exclusion criteria, follow-up times, complications analysis; surgical and functional outcomes. CONCLUSION TORS SGL is an effective approach for treating patients with early stages supraglottic cancers. Future controlled studies are needed to compare functional and survival outcomes between TORS SGL and other surgical approaches. Recommendations have been provided for future studies for better inclusion of patients, analysis of complications and functional outcomes.
Collapse
Affiliation(s)
- Jerome R Lechien
- Robotic Surgery Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), France; Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium; Department of Otolaryngology-Head Neck Surgery, Foch Hospital, UFR Simone Veil, University Versailles Saint-Quentin-en Yvelines (University Paris Saclay), Paris, France; Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium.
| | - Nicolas Fakhry
- Robotic Surgery Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), France; Department of Otorhinolaryngology-Head & Neck Surgery, APHM, Aix Marseille University, La Conception University Hospital, Marseille, France
| | - Sven Saussez
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium; Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Carlos-Miguel Chiesa-Estomba
- Robotic Surgery Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), France; Department of Otorhinolaryngology-Head & Neck Surgery, Hospital Universitario Donostia, San Sebastian, Spain
| | - Younes Chekkoury-Idrissi
- Robotic Surgery Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), France; Department of Otolaryngology-Head Neck Surgery, Foch Hospital, UFR Simone Veil, University Versailles Saint-Quentin-en Yvelines (University Paris Saclay), Paris, France
| | - Giovanni Cammaroto
- Robotic Surgery Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), France; Unit of Otolaryngology, Hospital Morgagni Pierantoni, Forlì, Italy
| | - Antoine E Melkane
- Robotic Surgery Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), France; Department of Otolaryngology-Head and Neck Surgery, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
| | - Maria Rosaria Barillari
- Robotic Surgery Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), France; Division of Phoniatrics and Audiology, Department of Mental and Physical Health and Preventive Medicine, University of Naples SUN, Naples, Italy
| | - Lise Crevier-Buchman
- Robotic Surgery Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), France; Department of Otolaryngology-Head Neck Surgery, Foch Hospital, UFR Simone Veil, University Versailles Saint-Quentin-en Yvelines (University Paris Saclay), Paris, France
| | - Tareck Ayad
- Robotic Surgery Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), France; Centre Hospitalier de l'Université de Montréal, Department of Otolaryngology-Head & Neck Surgery, Montreal, Quebec, Canada
| | - Marc Remacle
- Robotic Surgery Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), France; Department of Otorhinolaryngology and Head and Neck Surgery, CH Luxembourg, Luxembourg
| | - Stéphane Hans
- Robotic Surgery Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), France; Department of Otolaryngology-Head Neck Surgery, Foch Hospital, UFR Simone Veil, University Versailles Saint-Quentin-en Yvelines (University Paris Saclay), Paris, France
| |
Collapse
|
16
|
Hassid S, Van der Vorst S, Delahaut G, Ambroise J, Lawson G. Transoral robotic surgery hypopharyngectomy (TORSH): feasibility and outcomes. Eur Arch Otorhinolaryngol 2020; 277:2883-2892. [DOI: 10.1007/s00405-020-05984-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/13/2020] [Indexed: 02/05/2023]
|
17
|
Hardman J, Liu Z, Brady G, Roe J, Kerawala C, Riva F, Clarke P, Kim D, Bhide S, Nutting C, Harrington K, Paleri V. Transoral robotic surgery for recurrent cancers of the upper aerodigestive tract—Systematic review and meta‐analysis. Head Neck 2020; 42:1089-1104. [DOI: 10.1002/hed.26100] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 12/04/2019] [Accepted: 01/28/2020] [Indexed: 11/09/2022] Open
Affiliation(s)
- John Hardman
- Head and Neck Unit The Royal Marsden NHS Foundation Trust London UK
- Institute of Cancer Research London UK
| | - ZiWei Liu
- Head and Neck Unit The Royal Marsden NHS Foundation Trust London UK
| | - Grainne Brady
- Department of Speech and Language Therapy The Royal Marsden NHS Foundation Trust London UK
| | - Justin Roe
- Department of Speech and Language Therapy The Royal Marsden NHS Foundation Trust London UK
- Department of Surgery and Cancer Imperial College London UK
- Department of Otolaryngology Head and Neck Surgery, Imperial College Healthcare NHS Trust London UK
| | - Cyrus Kerawala
- Head and Neck Unit The Royal Marsden NHS Foundation Trust London UK
| | - Francesco Riva
- Head and Neck Unit The Royal Marsden NHS Foundation Trust London UK
| | - Peter Clarke
- Head and Neck Unit The Royal Marsden NHS Foundation Trust London UK
- Department of Otolaryngology Head and Neck Surgery, Imperial College Healthcare NHS Trust London UK
| | - Dae Kim
- Head and Neck Unit The Royal Marsden NHS Foundation Trust London UK
- Institute of Cancer Research London UK
| | - Shreerang Bhide
- Head and Neck Unit The Royal Marsden NHS Foundation Trust London UK
- Institute of Cancer Research London UK
| | - Christopher Nutting
- Head and Neck Unit The Royal Marsden NHS Foundation Trust London UK
- Institute of Cancer Research London UK
| | - Kevin Harrington
- Head and Neck Unit The Royal Marsden NHS Foundation Trust London UK
- Institute of Cancer Research London UK
| | - Vinidh Paleri
- Head and Neck Unit The Royal Marsden NHS Foundation Trust London UK
- Institute of Cancer Research London UK
| |
Collapse
|
18
|
The future of robotic surgery in otolaryngology – head and neck surgery. Oral Oncol 2020; 101:104510. [DOI: 10.1016/j.oraloncology.2019.104510] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 11/30/2019] [Accepted: 12/03/2019] [Indexed: 12/29/2022]
|
19
|
Kalantari F, Rajaeih S, Daneshvar A, Karbasi Z, Mahdi Salem M. Robotic surgery of head and neck cancers, a narrative review. Eur J Transl Myol 2020. [DOI: 10.4081/ejtm.2020.8727] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Head and neck cancers are the most common cancers in the body. Treatments are determined on the basis of the location and stage of the primary tumor. The goal of treatment is to eliminate the tumor, prevent recurrence or metastasis, and maintain the quality of life. There are several treatments available for the management of head and neck cancers, including surgery, radiation therapy, chemotherapy, new molecular agents, and a combination of them. Transoral robotic technique is a short-time operation using a type of robotic machine in which the patient undergoes anesthesia for a shorter time and the side effects of this operation and the time of hospitalization are less than open surgery. Due to the importance of speed and accuracy in head and neck cancer surgery and the importance of application of robotics in surgery, the present study was designed and implemented to review the application of robotics in the management of head and neck cancers. In this review study, the keywords: application, robotic, surgical, head cancer, transoral robotic surgery (TORS), and neck cancer, were searched in ISI, PubMed, Scopus, Google scholar databases. Related articles written domestically or abroad that have covered areas such as the background of transoral robotic surgery, maintaining organ function and approaches, the advantages and disadvantages of TORS, the affordability of TORS, the combination of TORS with other therapeutic approaches published from 2003 to 2019 were reviewed. The use of robotic surgery for precise operations such as head and neck cancers seems to be essential. More advanced robotic devices are expected to expand the surgery treatment for head and neck cancers as well as the results of using TORS for oncologic optimization and acceptability of results while maintaining organ function and patient's quality of life.
Collapse
|
20
|
Jelinek MJ, Howard AS, Haraf DJ, Vokes EE. Management of Early Head and Neck Cancer in Elderly Patients. J Oncol Pract 2019; 14:541-546. [PMID: 30285530 DOI: 10.1200/jop.18.00078] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) frequently affects elderly patients. Given the frailty and comorbid conditions of this population as well as the potential toxicities associated with treatment, there is a risk of undertreatment in older patients. However, there is growing evidence that benefit with standard treatment is similar in the elderly and in younger patients. Few prospective trials specifically target the elderly, which forces clinicians to rely on subgroup analyses and retrospective data. Therefore, adequate pretreatment assessments are vital to anticipate factors that may contribute to morbidity during therapy. In addition, supportive care during treatment is essential. For patients of all ages who present with early or localized disease, curative treatment should be offered whenever possible. With more precise surgical and radiologic techniques, the ability to provide curative treatment while minimizing long-term toxicity has greatly improved. Not only our techniques but also our understanding of the disease have improved. Human papillomavirus (HPV)-related HNSCC has changed the treatment paradigm of advanced-stage disease because of the inherently better prognosis compared with tobacco- and alcohol-related HNSCC. How this will affect early-stage disease remains to be seen, but de-escalated therapy may prove a suitable strategy in eligible elderly patients. With improved therapies and understanding of the disease, additional prospective trials must be carried out in the elderly population.
Collapse
|
21
|
Hanna J, Brauer PR, Morse E, Judson B, Mehra S. Is robotic surgery an option for early T‐stage laryngeal cancer? Early nationwide results. Laryngoscope 2019; 130:1195-1201. [DOI: 10.1002/lary.28144] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/13/2019] [Accepted: 05/31/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Jonathan Hanna
- Department of Surgery, Section of OtolaryngologyYale University School of Medicine New Haven Connecticut
| | - Philip R. Brauer
- Department of Surgery, Section of OtolaryngologyYale University School of Medicine New Haven Connecticut
| | - Elliot Morse
- Department of Surgery, Section of OtolaryngologyYale University School of Medicine New Haven Connecticut
| | - Benjamin Judson
- Department of Surgery, Section of OtolaryngologyYale University School of Medicine, Yale–New Haven Hospital, Yale Cancer Center New Haven Connecticut U.S.A
| | - Saral Mehra
- Department of Surgery, Section of OtolaryngologyYale University School of Medicine, Yale–New Haven Hospital, Yale Cancer Center New Haven Connecticut U.S.A
| |
Collapse
|
22
|
Golusiński W. Functional Organ Preservation Surgery in Head and Neck Cancer: Transoral Robotic Surgery and Beyond. Front Oncol 2019; 9:293. [PMID: 31058091 PMCID: PMC6479210 DOI: 10.3389/fonc.2019.00293] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 03/29/2019] [Indexed: 12/11/2022] Open
Abstract
In recent years, interest in functional organ preservation surgery (FOPS) in the treatment of head and neck cancer has increased dramatically as clinicians seek to minimize the adverse effects of treatment while maximizing survival and quality of life. In this context, the use of transoral robotic surgery (TORS) is becoming increasingly common. TORS is a relatively new and rapidly-evolving technique, with a growing range of treatment indications. A wide range of novel, flexible surgical robots are now in development and their commercialization is expected to significantly expand the current indications for TORS. In the present review, we discuss the current and future role of this organ-preserving modality as the central element in the multimodal treatment of head and neck cancer.
Collapse
Affiliation(s)
- Wojciech Golusiński
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, Poznan, Poland
| |
Collapse
|
23
|
Meta-analytic comparison of robotic and transoral laser surgical procedures in supraglottic carcinoma. J Laryngol Otol 2019; 133:404-412. [DOI: 10.1017/s0022215119000707] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveTo assess published reports of oncological surgical success rates in patients who underwent transoral laser supraglottic surgery and robotic surgery for supraglottic cancer.MethodsA systematic review of the literature was conducted and a meta-analysis of published data was performed. PubMed, Sage, Medline and Cochrane data sources were investigated. Overall survival rates, disease-specific survival rates, additional treatments and recurrence rates were investigated to determine the success of the surgical procedures.ResultsThe meta-analysis included 24 studies; 1617 studies were excluded. There were no statistically significant differences between the transoral laser supraglottic surgery and transoral robotic supraglottic surgery groups in terms of overall survival (77.0 per cent and 82.4 per cent respectively) and disease-specific survival (75.8 per cent and 87.0 per cent respectively). There was recurrence in 164 out of 832 patients (19.7 per cent) in the transoral laser supraglottic surgery group and in only 6 out of 66 patients (9 per cent) in the transoral robotic supraglottic surgery group.ConclusionTransoral laser surgery and robotic surgery appear to have comparable and acceptable oncological success rates.
Collapse
|
24
|
Oncological outcomes of early glottic carcinoma treated with transoral robotic surgery. Auris Nasus Larynx 2019; 46:285-293. [DOI: 10.1016/j.anl.2018.08.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 08/20/2018] [Accepted: 08/23/2018] [Indexed: 11/22/2022]
|
25
|
Orosco RK, Tam K, Nakayama M, Holsinger FC, Spriano G. Transoral supraglottic laryngectomy using a next‐generation single‐port robotic surgical system. Head Neck 2019; 41:2143-2147. [DOI: 10.1002/hed.25676] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 12/04/2018] [Accepted: 01/09/2019] [Indexed: 11/11/2022] Open
Affiliation(s)
- Ryan K. Orosco
- Division of Head and Neck Surgery, Department of SurgeryUniversity of California San Diego California
| | - Kenric Tam
- Division of Head and Neck Surgery, Department of OtolaryngologyStanford University California
| | - Meijin Nakayama
- Department of Otolaryngology‐Head and Neck SurgeryYokohama City University Yokohama Japan
| | | | - Giuseppe Spriano
- Department of Otolaryngology ‐ Head & Neck Surgery“Regina Elena” National Cancer Institute Rome Italy
| |
Collapse
|
26
|
Patel KB, Lin C, Kramer S, Fada C, Ozer E. Transoral robotic excision of laryngocele: Surgical considerations. Head Neck 2019; 41:1140-1143. [PMID: 30652374 DOI: 10.1002/hed.25612] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 10/28/2018] [Accepted: 12/10/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Transoral robotic surgery (TORS) has emerged as a novel, safe, and feasible procedure for the resection of malignant supraglottic laryngeal cancers. The purpose of this study was to demonstrate the surgical technique with extension of the use of TORS to excise a laryngeal cyst. RESULTS Laryngeal cyst resection, along with its tract, was accomplished with preservation of both false and true vocal cords. There was no perioperative or early postoperative complications. The patient was extubated immediately after surgery. Oral diet was initiated within 24 hours. No tracheostomy was required. A video demonstration of the surgical technique is included on Head & Neck's website. CONCLUSION TORS is a safe and feasible procedure for excision of selected laryngeal cysts.
Collapse
Affiliation(s)
- Krupal B Patel
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Chen Lin
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Scott Kramer
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Craig Fada
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Enver Ozer
- Department of Otolaryngology-Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio
| |
Collapse
|
27
|
|
28
|
Gupta K, Dabas S, Ranjan R, Sharma A, Shukla H. Oncological outcome following TORS in HPV negative supraglottic carcinoma. Indian J Cancer 2019; 56:9-14. [DOI: 10.4103/ijc.ijc_172_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
29
|
van der Woerd B, Patel KB, Nichols AC, Fung K, Yoo J, MacNeil SD. Functional outcomes in early (T1/T2) supraglottic cancer: a systematic review. J Otolaryngol Head Neck Surg 2018; 47:76. [PMID: 30563567 PMCID: PMC6299571 DOI: 10.1186/s40463-018-0321-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Accepted: 11/22/2018] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Organ preserving surgery (OPS) and radiotherapy (RT) are both accepted treatment options for early stage supraglottic cancer (SGC). Radiation has supplanted surgery in most cases, because of the perception that surgery results in poorer functional outcomes. However, evidence suggests that OPS with a neck dissection may be associated with improved survival. Our objective was to conduct a systematic review of the literature to compare functional outcomes of OPS and RT for early SGC. METHODS We searched Medline, EMBASE and Cochrane Central Register of Controlled Trials to identify studies. Studies were included if they reported functional outcomes on 10 or more patients with early stage SGC treated with radiation or OPS, including open partial laryngectomy, transoral laser microsurgery (TLM) or transoral robotic surgery (TORS). Two reviewers independently screened articles for relevance using pre-determined criteria. RESULTS From 7720 references, we included 10 articles (n = 640 patients). 50% (n = 320) of patients were treated with surgery. Three head-to-head RT versus OPS papers were included, however different outcome measures were used for each group. Intractable aspiration management (including total laryngectomy or permanent tracheostomy) following OPS was reported in five papers representing 186 patients; the definitive intractable aspiration management rate was 2.6% (95% CI 1.0-6.8%). Four papers reported permanent G-tube rate for the surgical group (n = 198), calculating a rate of 5.3% (95% CI 2.6-10.5%), this was not reported for the RT group in any papers. One study reported quality of life. Two studies reported objective voice measures. CONCLUSIONS This systematic review revealed a paucity of objective measures and significant data heterogeneity, rendering the comparison of functional outcomes following OPS versus RT for early SGC limited. Future research should include objective measures of functional outcomes including laryngectomy rate, g-tube rate, tracheostomy dependence, quality of life, and voice quality measures.
Collapse
Affiliation(s)
- Benjamin van der Woerd
- Department of Otolaryngology, Head & Neck Surgery, Schulich Medicine & Dentistry, Western University, London Health Sciences Centre, Victoria Hospital, London, Ontario, Canada
| | - Krupal B Patel
- Department of Otolaryngology, Head and Neck Surgery, The Ohio State University, Columbus, OH, USA
| | - Anthony C Nichols
- Department of Otolaryngology, Head & Neck Surgery, Schulich Medicine & Dentistry, Western University, London Health Sciences Centre, Victoria Hospital, London, Ontario, Canada
| | - Kevin Fung
- Department of Otolaryngology, Head & Neck Surgery, Schulich Medicine & Dentistry, Western University, London Health Sciences Centre, Victoria Hospital, London, Ontario, Canada
| | - John Yoo
- Department of Otolaryngology, Head & Neck Surgery, Schulich Medicine & Dentistry, Western University, London Health Sciences Centre, Victoria Hospital, London, Ontario, Canada
| | - S Danielle MacNeil
- Department of Otolaryngology, Head & Neck Surgery, Schulich Medicine & Dentistry, Western University, London Health Sciences Centre, Victoria Hospital, London, Ontario, Canada.
| |
Collapse
|
30
|
Cernea CR, Matos LL, de Carlucci Junior D, Leonhardt FD, Haddad L, Walder F. Transoral robotic supraglottic partial laryngectomy: report of the first Brazilian case. Braz J Otorhinolaryngol 2018; 84:660-664. [PMID: 27269129 PMCID: PMC9452258 DOI: 10.1016/j.bjorl.2016.01.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 01/16/2016] [Indexed: 11/30/2022] Open
Affiliation(s)
- Claudio Roberto Cernea
- Universidade de São Paulo (USP), Faculdade de Medicina, Disciplina de Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Leandro Luongo Matos
- Universidade de São Paulo (USP), Faculdade de Medicina, Disciplina de Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil.
| | - Dorival de Carlucci Junior
- Universidade de São Paulo (USP), Faculdade de Medicina, Disciplina de Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| | - Fernando Danelon Leonhardt
- Universidade Federal de São Paulo (UNIFESP), Disciplina de Otorrinolaringologia - Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| | - Leonardo Haddad
- Universidade Federal de São Paulo (UNIFESP), Disciplina de Otorrinolaringologia - Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| | - Fernando Walder
- Universidade Federal de São Paulo (UNIFESP), Disciplina de Otorrinolaringologia - Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| |
Collapse
|
31
|
Abstract
A look at the past, present and future.
Collapse
Affiliation(s)
- George Garas
- Department of Otorhinolaryngology - Head and Neck Surgery St Mary's Hospital, Imperial College London
| | - Neil Tolley
- Department of Otorhinolaryngology - Head and Neck Surgery St Mary's Hospital, Imperial College London
| |
Collapse
|
32
|
Stubbs VC, Rajasekaran K, Gigliotti AR, Mahmoud AF, Brody RM, Newman JG, Rassekh CH, Weinstein GS. Management of the Airway for Transoral Robotic Supraglottic Partial Laryngectomy. Front Oncol 2018; 8:312. [PMID: 30155444 PMCID: PMC6102950 DOI: 10.3389/fonc.2018.00312] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 07/23/2018] [Indexed: 11/13/2022] Open
Abstract
Introduction: Over the last several decades, transoral resection techniques for treatment of supraglottic lesions have become increasingly favored to reduce the need for either open transcervical resection or primary chemoradiation. Transoral robotic surgery (TORS) offers advantages in visualization, dissection control, and access to remove bulky tumors en bloc. However, the management of the airway for these cases tends to vary, without clear guidelines as to when a tracheostomy is necessary. Materials and Methods: A retrospective review of all patients who underwent transoral robotic supraglottic partial laryngectomy at a large academic center from May 2005 through December 2016 was performed. Airway management was examined, specifically as it pertains to whether a tracheostomy was performed at the time of surgery or otherwise. Demographic and tumor characteristics were also evaluated. Results: Sixty-three patients were included. Forty (63%) were male, the average age at surgery was 63.6, and the majority (90.5%) underwent resection for squamous cell carcinoma of the supraglottis. Thirty-nine patients (62%) underwent the procedure with standard endotracheal intubation using a wire-reinforced tube. Of these, four patients required subsequent tracheostomy- 2 for laryngeal edema postoperatively, one for airway management during a postoperative bleeding event, and one for laryngeal edema following initiation of adjuvant chemoradiation. Twenty patients (32%) underwent tracheostomy at the time of transoral resection for airway management, 17 of whom were decannulated an average of 12.2 weeks following surgery. Those who underwent tracheostomy at the time of surgery had a higher percentage of tumors involving multiple supraglottic subsites (p = 0.031), 85 vs. 54% in the group who did not undergo tracheostomy. No difference in age, BMI, clinical T-stage, or clinical N stage was found between the two groups. Conclusion: Performing a tracheostomy at the time of surgery should be considered for those patients with more extensive malignant disease (≥T2 tumors). While avoiding tracheostomy is often preferred by the patient, the maintenance of the patent airway peri-operatively should be first priority when considering airway management. Furthermore, as the majority of those patients receiving tracheostomy are decannulated within 4 months of surgery, the tracheostomy could be considered a short-term adjunct to the procedure.
Collapse
Affiliation(s)
- Vanessa C Stubbs
- Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, United States
| | - Karthik Rajasekaran
- Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, United States
| | - Adam R Gigliotti
- Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, United States
| | - Ahmad F Mahmoud
- Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, United States
| | - Robert M Brody
- Department of Otorhinolaryngology: Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, United States
| | - Jason G Newman
- Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, United States
| | - Christopher H Rassekh
- Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, United States
| | - Gregory S Weinstein
- Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, United States
| |
Collapse
|
33
|
Comparison of functional and oncological treatment outcomes after transoral robotic surgery and open surgery for supraglottic laryngeal cancer. J Laryngol Otol 2018; 132:832-836. [DOI: 10.1017/s0022215118001305] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveTo compare functional and oncological treatment outcomes among patients with supraglottic laryngeal cancers who underwent transoral robotic supraglottic laryngectomy and open supraglottic laryngectomy.MethodsA retrospective chart review was conducted of 17 patients treated by transoral robotic supraglottic laryngectomy and 20 patients treated by open supraglottic laryngectomy.ResultsNo tracheostomy or prolonged intubation was needed in the transoral robotic surgery group. Furthermore, that group had a shorter oral feeding time, hospitalisation and recovery period. There was no difference between groups in terms of complications. There were no differences in overall survival time and disease-specific survival time between groups.ConclusionTransoral robotic supraglottic laryngectomy for supraglottic laryngeal cancer is an oncologically safe and functional procedure with better results when compared to conventional open surgery.
Collapse
|
34
|
Doazan M, Hans S, Morinière S, Lallemant B, Vergez S, Aubry K, De Monès E, Espitalier F, Jegoux F, Pradat P, Céruse P. Oncologic outcomes with transoral robotic surgery for supraglottic squamous cell carcinoma: Results of the French Robotic Surgery Group of GETTEC. Head Neck 2018; 40:2050-2059. [DOI: 10.1002/hed.25199] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 09/22/2017] [Accepted: 03/15/2018] [Indexed: 12/24/2022] Open
Affiliation(s)
- Marianne Doazan
- Department of Head and Neck Surgery, Hospices Civils de Lyon; University Hospital Lyon-Nord; Lyon France
| | - Stéphane Hans
- Department of Head and Neck Surgery, Assistance Publique Hôpitaux de Paris; Hôpital Européen Georges Pompidou; Paris France
| | - Sylvain Morinière
- Department of Head and Neck Surgery; University Hospital Bretonneau; Tours France
| | - Benjamin Lallemant
- Department of Head and Neck Surgery; University Hospital Carémeau; Nîmes France
| | - Sébastien Vergez
- Department of Head and Neck Surgery; University Hospital Rangueil-Larrey; Toulouse France
| | - Karine Aubry
- Department of Head and Neck Surgery; University Hospital Dupuytren; Limoges France
| | - Erwan De Monès
- Department of Head and Neck Surgery; University Hospital Pellegrin; Bordeaux France
| | - Florent Espitalier
- Department of Head and Neck Surgery; University Hospital Hôtel-Dieu; Nantes France
| | - Franck Jegoux
- Department of Head and Neck Surgery; University hospital Pontchaillou; Rennes France
| | - Pierre Pradat
- Clinical Research Committee, Hospices Civils de Lyon; University Hospital Lyon-Nord; France
| | - Philippe Céruse
- Department of Head and Neck Surgery, Hospices Civils de Lyon; University Hospital Lyon-Nord; Lyon France
- Université Claude Bernard; Lyon France
| |
Collapse
|
35
|
Gorphe P. A Contemporary Review of Evidence for Transoral Robotic Surgery in Laryngeal Cancer. Front Oncol 2018; 8:121. [PMID: 29721446 PMCID: PMC5915483 DOI: 10.3389/fonc.2018.00121] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 04/04/2018] [Indexed: 12/03/2022] Open
Abstract
Numerous studies have shown that transoral robotic surgery (TORS) for oropharyngeal cancers is safe and that it yields satisfactory functional and oncological outcomes. For many teams worldwide, it is therefore a standard surgical approach with eligible patients. In the same time, TORS is increasingly being used and described in the context of laryngeal cancer surgery. It is proposed as an alternative to open approaches, which may yield inconsistent functional results and significant rates of postoperative complications. It may also be an alternative to definitive radiotherapy, which entails significant early and late toxicities. Moreover, it has been explored as an alternative to endoscopic laser surgery in patients with difficult exposure, even though there is still a lack of evidence about which procedure provides better vizualization of the vocal cords. This article provides a review of the indications for TORS in laryngeal cancer, the peri-operative morbidity, functional outcomes, and oncological results.
Collapse
Affiliation(s)
- Philippe Gorphe
- Department of Head and Neck Oncology, Institute Gustave Roussy, Université Paris-Saclay, Villejuif, France
| |
Collapse
|
36
|
Abstract
In the head and neck region, great potential is seen in robot-assisted surgery (RAS). Mainly in cancer surgery, the use of robotic systems seems to be of interest. Until today, two robotic systems (DaVinci® und FLEX®) have gained approval for clinical use in the head and neck region, and multiple other systems are currently in pre-clinical testing. Although, certain groups of patients may benefit from RAS, no unbiased randomized clinical studies are available. Until today, it was not possible to satisfactorily prove any advantage of RAS as compared to standard procedures. The limited clinical benefit and the additional financial burden seem to be the main reasons, why the comprehensive application of RAS has not been realized so far.This review article describes the large variety of clinical applications for RAS in the head and neck region. In addition, the financial and technical challenges, as well as ongoing developments of RAS are highlighted. Special focus is put on risks associated with RAS and current clinical studies. We believe, that RAS will find its way into clinical routine during the next years. Therefore, medical staff will have to increasingly face the technical, scientific and ethical features of RAS.
Collapse
Affiliation(s)
- Patrick J Schuler
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm
| |
Collapse
|
37
|
Patel KB, Nichols AC, Fung K, Yoo J, MacNeil SD. Treatment of early stage Supraglottic squamous cell carcinoma: meta-analysis comparing primary surgery versus primary radiotherapy. J Otolaryngol Head Neck Surg 2018; 47:19. [PMID: 29506564 PMCID: PMC5839014 DOI: 10.1186/s40463-018-0262-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 01/31/2018] [Indexed: 11/10/2022] Open
Abstract
Objectives For early stage supraglottic squamous cell carcinoma (SCC), single modality treatment either in the form of primary organ preservation surgery alone or radiation alone is recommended. Thus, a definite treatment strategy for early stage supraglottic SCC remains undefined. The primary objective of this study was to conduct a systematic review and meta-analysis comparing the oncologic outcomes of surgery and radiotherapy in early stage (Stage I and II) T1 N0 and T2 N0 supraglottic SCC. Methods Systematic methods were used to identify published and unpublished data. Two reviewers independently screened all titles, abstracts and articles for relevance using predefined criteria. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Results Five studies met the inclusion criteria for disease specific mortality with a total of 2864 pooled patients. 5-year disease specific mortality was lower in the surgery group (ORs 0.43, 95% CI 0.31–0.60). Four studies met the inclusion criteria for 5-year overall mortality with a total of 2790 pooled patients. Five-year overall mortality was lower in surgery group (ORs 0.40, 95% CI 0.29–0.55). Conclusions This is the first study to examine the management of early stage supraglottic SCC using meta-analytic methodology. Our results suggest that primary surgery may result in decreased disease specific and overall mortality compared to primary radiotherapy.
Collapse
Affiliation(s)
- Krupal B Patel
- Department of Otolaryngology - Head & Neck Surgery, Schulich Medicine & Dentistry, London Health Sciences Centre, Western University, Victoria Hospital, London, ON, Canada
| | - Anthony C Nichols
- Department of Otolaryngology - Head & Neck Surgery, Schulich Medicine & Dentistry, London Health Sciences Centre, Western University, Victoria Hospital, London, ON, Canada
| | - Kevin Fung
- Department of Otolaryngology - Head & Neck Surgery, Schulich Medicine & Dentistry, London Health Sciences Centre, Western University, Victoria Hospital, London, ON, Canada
| | - John Yoo
- Department of Otolaryngology - Head & Neck Surgery, Schulich Medicine & Dentistry, London Health Sciences Centre, Western University, Victoria Hospital, London, ON, Canada
| | - S Danielle MacNeil
- Department of Otolaryngology - Head & Neck Surgery, Schulich Medicine & Dentistry, London Health Sciences Centre, Western University, Victoria Hospital, London, ON, Canada.
| |
Collapse
|
38
|
Chan JYW, Chan RCL, Chow VLY, Tsang RKY, Wong STS, Wei WI. Transoral robotic total laryngopharyngectomy and free jejunal flap reconstruction for hypopharyngeal cancer. Oral Oncol 2017; 72:194-196. [DOI: 10.1016/j.oraloncology.2017.06.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 06/22/2017] [Accepted: 06/29/2017] [Indexed: 10/19/2022]
|
39
|
Abstract
OPINION STATEMENT Given the potential for long-term toxicities from concurrent chemoradiation, there is great interest in surgery as a primary treatment modality for head and neck cancers, particularly in the younger HPV-positive oropharyngeal cancer patient. Transoral robotic surgery (TORS) has proven to be an effective technique to safely treat oropharyngeal and select supraglottic tumors surgically. Sound, traditional surgical principles are employed using improved endoscopic visualization and precise instrumentation to perform oncologic surgery without the morbidity of transmandibular or transcervical approaches. Although level 1 evidence prospective clinical trials are currently underway for TORS, the literature supports its safety and efficacy based on numerous studies. Currently, prospective randomized trials are underway to provide better evidence for or against TORS in oropharyngeal cancer. Patient selection based on comorbidities, anatomy, and available pathological data is critical in choosing patients for TORS.
Collapse
|
40
|
Radiotherapy Alone or With Chemotherapy in the Management of Carcinoma of the Supraglottic Larynx: A 25-Year Community Hospital Experience. Am J Clin Oncol 2017; 41:894-897. [PMID: 28654571 DOI: 10.1097/coc.0000000000000398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The purpose of this study was to retrospectively review outcomes for patients treated with definitive radiotherapy for carcinoma of the supraglottic larynx at a community hospital and to compare our results with the literature. MATERIALS AND METHODS Treatment records of 46 patients with localized carcinoma of the supraglottic larynx treated from January 1987 through January 2012 were reviewed. Overall, 18 (39%) presented with stage I or II disease, whereas 28 (61%) presented with stage III to IV. In total, 30 patients (65%) were treated using hyperfractionation, whereas 16 (35%) received once-daily fractionation. Twelve patients (26%) received concurrent chemotherapy with weekly cisplatin. The Kaplan-Meier method was used to assess outcomes. RESULTS The median follow-up for the living patients was 6.7 years (range, 1.7 to 23.1 y). At 5 years, the local-regional control (LRC), ultimate LRC, laryngeal preservation, and overall survival (OS) rates were 70%, 82%, 65%, and 53%, respectively. At 5 years, disease-free survival and cause-specific survival rates were 75% and 76%, respectively. The 5-year OS rates by American Joint Committee on Cancer stage were as follows: I to II, 61%; III, 51%; and IV, 44%. For those receiving concurrent chemotherapy, there was no improvement in 5-year LRC (83% vs. 66%; P=0.4081) or OS (55% vs. 50%; P=0.7697). For those receiving hyperfractionation, there was no improvement in 5-year LRC (75% vs. 63%; P=0.3369) or OS (55% vs. 50%; P=0.4161). CONCLUSIONS Our outcomes are similar to those reported in the literature. Neither hyperfractionation nor chemotherapy appeared to confer a benefit for disease control or OS possibly owing to small sample size and the inherent bias of a retrospective review.
Collapse
|
41
|
Imanishi Y, Ozawa H, Sakamoto K, Fujii R, Shigetomi S, Habu N, Otsuka K, Sato Y, Watanabe Y, Sekimizu M, Ito F, Tomita T, Ogawa K. Clinical outcomes of transoral videolaryngoscopic surgery for hypopharyngeal and supraglottic cancer. BMC Cancer 2017. [PMID: 28651556 PMCID: PMC5485567 DOI: 10.1186/s12885-017-3396-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background Transoral videolaryngoscopic surgery (TOVS) was developed as a new distinct surgical procedure for hypopharyngeal cancer (HPC) and supraglottic cancer (SGC) staged at up to T3. However, long-term treatment outcomes of TOVS remain to be validated. Methods Under a straight broad intraluminal view provided by combined use of a distending laryngoscope and a videolaryngoscope, we performed en bloc tumor resection via direct bimanual handling of the ready-made straight-form surgical instruments and devices. We retrospectively analyzed functional and oncologic outcomes of 72 patients with HPC (n = 58) or SGC (n = 14) whose minimum follow-up was 24 months or until death. Results The cohort comprised nine patients of Tis, 23 of T1, 33 of T2, and 7 of T3. Among 36 patients (50%) who underwent neck dissection simultaneously, all but one were pathologically node-positive. Twelve patients underwent postoperative concurrent chemoradiation (CCRT) as adjuvant treatment, and another four patients underwent radiation or CCRT for second or later primary cancer. The endotracheal tube was removed in an operation room in all but two patients who underwent temporary tracheostomy. Pharyngeal fistula was formed transiently in two patients. The median time until patients resumed oral intake and could take a soft meal was 2 and 5 days, respectively. Eventually, 69 patients (96%) took normal meals. The 5-year cause-specific survival (CSS), overall survival (OS), larynx-preserved CSS, and loco-regional controlled CSS were 87.3%, 77.9%, 86.0%, and 88.0%, respectively. Multivariate analysis revealed N2-3 as an independent prognostic factor in both CSS (hazard ratio [HR] = 25.51, P = 0.008) and OS (HR = 4.90, P = 0.022), which indirectly reflected higher risk of delayed distant metastasis. Conclusions Considering its sound functional and oncological outcomes with various practical advantages, TOVS can be a dependable, less invasive, and cost-effective surgical option of an organ-function preservation strategy for HPC and SGC.
Collapse
Affiliation(s)
- Yorihisa Imanishi
- Department of Otorhinolaryngology-Head and Neck Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan. .,Department of Otorhinolaryngology, Kawasaki Municipal Kawasaki Hospital, Kawasaki, Kanagawa, 210-0013, Japan.
| | - Hiroyuki Ozawa
- Department of Otorhinolaryngology-Head and Neck Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Koji Sakamoto
- Department of Otorhinolaryngology, Saiseikai Utsunomiya Hospital, Utsunomiya, Tochigi, 321-0974, Japan
| | - Ryoichi Fujii
- Department of Otorhinolaryngology, Saiseikai Yokohamashi Nanbu Hospital, Yokohama, Kanagawa, 234-0054, Japan
| | - Seiji Shigetomi
- Department of Otorhinolaryngology, Yokohama Municipal Citizen's Hospital, Yokohama, Kanagawa, 240-8555, Japan
| | - Noboru Habu
- Department of Otorhinolaryngology, Kyosai Tachikawa Hospital, Tachikawa, Tokyo, 190-0022, Japan
| | - Kuninori Otsuka
- Department of Otorhinolaryngology, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Kanagawa, 230-8765, Japan
| | - Yoichiro Sato
- Department of Otorhinolaryngology, Kawasaki Municipal Kawasaki Hospital, Kawasaki, Kanagawa, 210-0013, Japan
| | - Yoshihiro Watanabe
- Department of Otorhinolaryngology-Head and Neck Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Mariko Sekimizu
- Department of Otorhinolaryngology-Head and Neck Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Fumihiro Ito
- Department of Otorhinolaryngology-Head and Neck Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Toshiki Tomita
- Department of Otorhinolaryngology-Head and Neck Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| | - Kaoru Ogawa
- Department of Otorhinolaryngology-Head and Neck Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
| |
Collapse
|
42
|
Liu HH, Li LJ, Shi B, Xu CW, Luo E. Robotic surgical systems in maxillofacial surgery: a review. Int J Oral Sci 2017; 9:63-73. [PMID: 28660906 PMCID: PMC5518975 DOI: 10.1038/ijos.2017.24] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2017] [Indexed: 12/26/2022] Open
Abstract
Throughout the twenty-first century, robotic surgery has been used in multiple oral surgical procedures for the treatment of head and neck tumors and non-malignant diseases. With the assistance of robotic surgical systems, maxillofacial surgery is performed with less blood loss, fewer complications, shorter hospitalization and better cosmetic results than standard open surgery. However, the application of robotic surgery techniques to the treatment of head and neck diseases remains in an experimental stage, and the long-lasting effects on surgical morbidity, oncologic control and quality of life are yet to be established. More well-designed studies are needed before this approach can be recommended as a standard treatment paradigm. Nonetheless, robotic surgical systems will inevitably be extended to maxillofacial surgery. This article reviews the current clinical applications of robotic surgery in the head and neck region and highlights the benefits and limitations of current robotic surgical systems.
Collapse
Affiliation(s)
- Hang-Hang Liu
- State Key Laboratory of Oral
Diseases, National Clinical Research Center for Oral Diseases, West China
Hospital of Stomatology, Sichuan University, Chengdu,
China
| | - Long-Jiang Li
- State Key Laboratory of Oral
Diseases, National Clinical Research Center for Oral Diseases, West China
Hospital of Stomatology, Sichuan University, Chengdu,
China
| | - Bin Shi
- State Key Laboratory of Oral
Diseases, National Clinical Research Center for Oral Diseases, West China
Hospital of Stomatology, Sichuan University, Chengdu,
China
| | - Chun-Wei Xu
- State Key Laboratory of Oral
Diseases, National Clinical Research Center for Oral Diseases, West China
Hospital of Stomatology, Sichuan University, Chengdu,
China
| | - En Luo
- State Key Laboratory of Oral
Diseases, National Clinical Research Center for Oral Diseases, West China
Hospital of Stomatology, Sichuan University, Chengdu,
China
| |
Collapse
|
43
|
Transoral surgery vs intensity-modulated radiotherapy for early supraglottic cancer. Curr Opin Otolaryngol Head Neck Surg 2017; 25:133-141. [DOI: 10.1097/moo.0000000000000345] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
44
|
Funk E, Goldenberg D, Goyal N. Demonstration of transoral robotic supraglottic laryngectomy and total laryngectomy in cadaveric specimens using the Medrobotics Flex System. Head Neck 2017; 39:1218-1225. [PMID: 28301093 DOI: 10.1002/hed.24746] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 11/19/2016] [Accepted: 01/11/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Current management of laryngeal malignancies is associated with significant morbidity. Application of minimally invasive transoral techniques may reduce the morbidity associated with traditional procedures. The purpose of this study was to present our investigation of the utility of a novel flexible robotic system for transoral supraglottic laryngectomy and total laryngectomy. METHODS Transoral total laryngectomy and transoral supraglottic laryngectomy were performed in cadaveric specimens using the Flex Robotic System (Medrobotics, Raynham, MA). RESULTS All procedures were completed successfully in the cadaveric models. The articulated endoscope allowed for access to the desired surgical site. Flexible instruments enabled an atraumatic approach and allowed for precise surgical technique. CONCLUSION Access to deep anatomic structures remains problematic using current minimally invasive robotic approaches. Improvements in visualization and access to the laryngopharyngeal complex offered by this system may improve surgical applications to the larynx. This study demonstrates the technical feasibility using the Flex Robotic System for transoral robotic supraglottic laryngectomy and total laryngectomy. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1218-1225, 2017.
Collapse
Affiliation(s)
- Emily Funk
- The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania
| | - David Goldenberg
- Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania
| | - Neerav Goyal
- Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania
| |
Collapse
|
45
|
Meulemans J, Vanclooster C, Vauterin T, D'heygere E, Nuyts S, Clement PM, Hermans R, Delaere P, Vander Poorten V. Up-front and Salvage Transoral Robotic Surgery for Head and Neck Cancer: A Belgian Multicenter Retrospective Case Series. Front Oncol 2017; 7:15. [PMID: 28232904 PMCID: PMC5298968 DOI: 10.3389/fonc.2017.00015] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Accepted: 01/23/2017] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION/AIM We analyzed the functional and oncologic outcomes of primary and salvage transoral robotic surgery (TORS) procedures, performed in three Belgian institutions with a similar philosophy. PATIENTS AND METHODS A total of 86 patients who underwent TORS between 24-12-2009 and 25-09-2015 were retrospectively reviewed. Descriptive statistics, overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS; Kaplan-Meier), and the variation of these outcomes according to whether patients had primary or salvage TORS were evaluated (univariate log-rank analysis). RESULTS Of 86 patients, 56 (65.1%) underwent TORS as a primary treatment and 30 (34.9%) as a salvage procedure for recurrent or second primary cancer. Tumor location was mainly oropharynx (N = 63; 73.3%) followed by supraglottic larynx (N = 11; 12.8%), hypopharynx (N = 11; 12.8%), and glottic larynx (N = 1; 1.2%). In the up-front TORS group, most tumors were classified as cT1 (N = 23; 41.1%)/pT1 (N = 24; 42.9%) or cT2 (N = 27; 48.2%)/pT2 (N = 27; 48.2%) and cN0 (N = 18; 32.1%), cN1 (N = 13; 23.2%), or cN2 (N = 25; 44.6%). In the salvage TORS group, most tumors were cT1-rT1 (N = 18; 60.0%)/pT1-rpT1 (N = 18; 60.0%) or cT2-rT2 (N = 12; 40.0%)/pT2-rpT2 (N = 7; 23.3%) and cN0 (N = 25; 83.3%). Neck dissection was performed in 87.5% of primary cases and 30.0% of salvage cases. In the up-front TORS group, patients were postoperatively submitted to follow-up (N = 13; 23.2%) or received adjuvant radiotherapy, either as single modality (N = 26; 46.4%) or with concomitant cisplatin (N = 15; 26.8%). On the other hand, most salvage TORS patients did not receive any adjuvant therapy (N = 19; 63.3%). Mean and median follow-up was 23.1 and 21.2 months, respectively. Functional results were excellent (no definitive tracheostomy, long-term tube feeding in 1.8% of primary cases, and 20% of salvage cases). In the up-front TORS group, estimated 2-year OS was 88.5% (SE = 5.0%), 2-year DSS was 91.8% (SE = 4.6%) and 2-year DFS was 86.1% (SE = 5.3%). In the salvage TORS group, estimated 2-year OS was 73.5% (SE = 10.9%), 2-year DSS was 93.3% (SE = 6.4%), and 2-year DFS was 75.8% (SE = 9.7%). Comparing outcome of primarily treated patients to salvage patients, a non-statistically significant trend toward better OS (p = 0.262) and DFS (p = 0.139) was observed. CONCLUSION This retrospective study confirms favorable oncologic and functional outcomes of TORS for selected head and neck malignancies, both in the primary and in the salvage setting.
Collapse
Affiliation(s)
- Jeroen Meulemans
- Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium
| | - Christophe Vanclooster
- Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium; Otorhinolaryngology-Head and Neck Surgery, AZ Sint-Lucas, Ghent, Belgium
| | - Tom Vauterin
- Otorhinolaryngology-Head and Neck Surgery, AZ Sint-Jan , Bruges , Belgium
| | - Emmanuel D'heygere
- Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium; Otorhinolaryngology-Head and Neck Surgery, AZ Sint-Jan, Bruges, Belgium
| | - Sandra Nuyts
- Radiation Oncology, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, Section Experimental Radiotherapy, KU Leuven, Leuven, Belgium
| | - Paul M Clement
- Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium; Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Robert Hermans
- Department of Radiology, University Hospitals Leuven , Leuven , Belgium
| | - Pierre Delaere
- Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven , Leuven , Belgium
| | - Vincent Vander Poorten
- Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium
| |
Collapse
|
46
|
|
47
|
Wiegand S. Evidence and evidence gaps of laryngeal cancer surgery. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2016; 15:Doc03. [PMID: 28025603 PMCID: PMC5169076 DOI: 10.3205/cto000130] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Surgical treatment of laryngeal cancer has been established for decades. In addition to total laryngectomy, which was first performed in 1873, a large number or organ preservation surgical techniques, like open partial laryngectomy, transoral laser microsurgery, and transoral robotic surgery have been developed. Studies on laryngeal cancer surgery are mainly retrospective case series and cohort studies. The evolution of chemoradiation protocols and their analysis in prospective randomized trials have led to an increasing acceptance of non-surgical treatment procedures. In addition to an improvement of prognosis, in recent years the preservation of function and maintenance of life quality after primary therapy of laryngeal cancer has increasingly become the focus of therapy planning. Significant late toxicity after chemoradiation has been identified as an important issue. This leads to a reassessment of surgical concepts and initiation of studies on laryngeal cancer surgery which was additionally stimulated by the advent of transoral robotic surgery in the US. Improving the evidence base of laryngeal cancer surgery by successful establishment of surgical trials should be the future goal.
Collapse
Affiliation(s)
- Susanne Wiegand
- Department of Otolaryngology, Head & Neck Surgery, University Hospital of Leipzig, Germany
| |
Collapse
|
48
|
Bekeny JR, Ozer E. Transoral robotic surgery frontiers. World J Otorhinolaryngol Head Neck Surg 2016; 2:130-135. [PMID: 29204557 PMCID: PMC5698526 DOI: 10.1016/j.wjorl.2016.05.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 05/12/2016] [Indexed: 10/30/2022] Open
Abstract
Transoral robotic surgery is a exciting field that continues to develop and push the boundaries of current procedural ability and challenges historical treatment paradigms. With the first use of a surgical robot in 1985, to the first clinical use of the robot transorally in 2005, there was some lag in adoption of robotic techniques in the head and neck region. However, since 2005 transoral robotic surgery has rapidly gained momentum amongst head and neck surgeons. With FDA approval of the da Vinci robot in 2009, transoral robotic surgery is currently offered as a treatment modality for malignant and nonmalignant disease of the head and neck region. This new technology is being used to reconsider historical treatment paradigms for malignancies of the upper aerodigestive tract due to the fact that minimally invasive surgical access to the oropharynx and larynx has been improved. Along with this enhanced access have come innovative procedures and uses of the technology for multiple facets of head and neck disease. Technology continues to improve and innovation in surgical robotics is expected to continue as more companies attempt to capture this market. This article aims to provide a view at the landscape of transoral robotic surgery and explore the future frontiers.
Collapse
Affiliation(s)
- James R Bekeny
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Medical Center, The James Cancer Hospital and Solove Research Institute, Columbus, OH 43210, USA
| | - Enver Ozer
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Medical Center, The James Cancer Hospital and Solove Research Institute, Columbus, OH 43210, USA
| |
Collapse
|
49
|
Lawson G, Van der vorst S, Desgain O, Bachy V. La chirurgie robotique en cancérologie ORL. ONCOLOGIE 2016. [DOI: 10.1007/s10269-016-2624-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
50
|
Schindler A, Pizzorni N, Mozzanica F, Fantini M, Ginocchio D, Bertolin A, Crosetti E, Succo G. Functional outcomes after supracricoid laryngectomy: what do we not know and what do we need to know? Eur Arch Otorhinolaryngol 2015; 273:3459-3475. [DOI: 10.1007/s00405-015-3822-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 10/29/2015] [Indexed: 10/22/2022]
|