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Janopaul-Naylor JR, Rupji M, Tobillo RA, Lorenz JW, Switchenko JM, Tian S, Kaka AS, Qian DC, Schlafstein AJ, Steuer CE, Remick JS, Rudra S, McDonald MW, Saba NF, Stokes WA, Patel MR, Bates JE. Ninety-day mortality following transoral robotic surgery or radiation at Commission on Cancer-accredited facilities. Head Neck 2023; 45:658-663. [PMID: 36549012 PMCID: PMC9898134 DOI: 10.1002/hed.27282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 11/29/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Postoperative mortality for oropharynx squamous cell carcinoma (OPSCC) with transoral robotic surgery (TORS) varies from 0.2% to 6.5% on trials; the real-world rate is unknown. METHODS NCDB study from 2010 to 2017 for patients with cT1-2N0-2M0 OPSCC with Charleson-Deyo score 0-1. Ninety-day mortality assessed from start and end of treatment at Commission on Cancer-accredited facilities. RESULTS 3639 patients were treated with TORS and 1937 with radiotherapy. TORS cohort had more women and higher income, was younger, more often treated at academic centers, and more likely to have private insurance (all p < 0.05). Ninety-day mortality was 1.3% with TORS and 0.7% or 1.4% from start or end of radiotherapy, respectively. From end of therapy, there was no significant difference on MVA between treatment modality. CONCLUSIONS There is minimal difference between 90-day mortality in patients treated with TORS or radiotherapy for early-stage OPSCC. While overall rates are low, for patients with expectation of cure, work is needed to identify optimal treatment.
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Affiliation(s)
- James R. Janopaul-Naylor
- Department of Radiation Oncology, Winship Cancer Institute at Emory University, Atlanta, Georgia, USA
| | - Manali Rupji
- Biostatistics Shared Resource, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA
| | - Rachel A. Tobillo
- Department of Radiation Oncology, Winship Cancer Institute at Emory University, Atlanta, Georgia, USA
| | - Joshua W. Lorenz
- Department of Radiation Oncology, Winship Cancer Institute at Emory University, Atlanta, Georgia, USA
| | - Jeffrey M. Switchenko
- Biostatistics Shared Resource, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health at Emory University, Atlanta, Georgia, USA
| | - Sibo Tian
- Department of Radiation Oncology, Winship Cancer Institute at Emory University, Atlanta, Georgia, USA
| | - Azeem S. Kaka
- Department of Otolaryngology, Winship Cancer Institute at Emory University, Atlanta, Georgia, USA
| | - David C. Qian
- Department of Radiation Oncology, Winship Cancer Institute at Emory University, Atlanta, Georgia, USA
| | - Ashley J. Schlafstein
- Department of Radiation Oncology, Winship Cancer Institute at Emory University, Atlanta, Georgia, USA
| | - Conor E. Steuer
- Department of Hematology and Medical Oncology, Winship Cancer Institute at Emory University, Atlanta, Georgia, USA
| | - Jill S. Remick
- Department of Radiation Oncology, Winship Cancer Institute at Emory University, Atlanta, Georgia, USA
| | - Soumon Rudra
- Department of Radiation Oncology, Winship Cancer Institute at Emory University, Atlanta, Georgia, USA
| | - Mark W. McDonald
- Department of Radiation Oncology, Winship Cancer Institute at Emory University, Atlanta, Georgia, USA
| | - Nabil F. Saba
- Department of Otolaryngology, Winship Cancer Institute at Emory University, Atlanta, Georgia, USA
- Department of Hematology and Medical Oncology, Winship Cancer Institute at Emory University, Atlanta, Georgia, USA
| | - William A. Stokes
- Department of Radiation Oncology, Winship Cancer Institute at Emory University, Atlanta, Georgia, USA
| | - Mihir R. Patel
- Department of Otolaryngology, Winship Cancer Institute at Emory University, Atlanta, Georgia, USA
| | - James E. Bates
- Department of Radiation Oncology, Winship Cancer Institute at Emory University, Atlanta, Georgia, USA
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