Abstract：
OBJECTIVE: Salvage surgery is still the best therapeutic option for resectable recurrent oropharyngeal squamous cell carcinoma (rOPSCC). Transoral robotic surgery may potentially reduce the morbidity of standard open approaches. The aim of the study is to present oncological and functional outcomes of a monocentric experience in salvage transoral robotic surgery.
METHODS: We performed a single-center retrospective analysis of patients submitted to transoral robotic salvage surgery with or without neck dissection for cT1-3 rOPSCC. We investigated complication rate, survival outcomes (Overall Survival, Disease Specific Survival, Loco-Regional Recurrence Free Survival) and functional outcomes (tracheal tube and/or gastrostomy dependence).
RESULTS: Sixty-one patients were included in the analysis. No major complications or perioperative deaths were recorded. The estimated 2-year OS was 76.7%, DSS 81.8% and LRRFS 50.5%. In multivariable analysis rpT, PNI (perineural infiltration) and HPV-positivity were significantly associated with LRRFS (Hazard Ratios: T3 vs T1 6.43, PNI yes vs no 4.19, HPV+ yes vs no 2.63). At last follow up, 97% of patients were tracheal tube-free, while 93% were gastrostomy-free.
CONCLUSIONS: Transoral robotic salvage surgery is a successful treatment in selected patients affected by rOPSCC because it grants good oncologic and functional outcomes.
METHODS: We performed a single-center retrospective analysis of patients submitted to transoral robotic salvage surgery with or without neck dissection for cT1-3 rOPSCC. We investigated complication rate, survival outcomes (Overall Survival, Disease Specific Survival, Loco-Regional Recurrence Free Survival) and functional outcomes (tracheal tube and/or gastrostomy dependence).
RESULTS: Sixty-one patients were included in the analysis. No major complications or perioperative deaths were recorded. The estimated 2-year OS was 76.7%, DSS 81.8% and LRRFS 50.5%. In multivariable analysis rpT, PNI (perineural infiltration) and HPV-positivity were significantly associated with LRRFS (Hazard Ratios: T3 vs T1 6.43, PNI yes vs no 4.19, HPV+ yes vs no 2.63). At last follow up, 97% of patients were tracheal tube-free, while 93% were gastrostomy-free.
CONCLUSIONS: Transoral robotic salvage surgery is a successful treatment in selected patients affected by rOPSCC because it grants good oncologic and functional outcomes.
摘要：
目的：挽救性手术仍然是可切除的复发性口咽鳞状细胞癌（rOPSCC）的最佳治疗选择。经口机器人手术可能会降低标准开放方法的发病率。该研究的目的是介绍抢救经口机器人手术中单中心经验的肿瘤和功能结果。
方法：我们对行cT1-3rOPSCC颈清扫术或无颈清扫术的患者进行了单中心回顾性分析。我们调查了并发症发生率，生存结果(总生存率，疾病特异性生存率,本地区域复发无生存）和功能结果（气管导管和/或胃造口术依赖）。
结果：61例患者纳入分析。无重大并发症或围手术期死亡记录。估计2年OS为76.7%，DSS81.8%和LRRFS50.5%。在多变量分析rpT中，PNI（神经周浸润）和HPV阳性与LRFS显着相关（危害比：T3vsT16.43，PNI是vs无4.19，HPV是vs无2.63）。最后跟进,97%的患者无气管导管,而93%的患者无胃造口术。
结论：经口机器人抢救手术是对受rOPSCC影响的特定患者的成功治疗，因为它具有良好的肿瘤学和功能预后。
方法：我们对行cT1-3rOPSCC颈清扫术或无颈清扫术的患者进行了单中心回顾性分析。我们调查了并发症发生率，生存结果(总生存率，疾病特异性生存率,本地区域复发无生存）和功能结果（气管导管和/或胃造口术依赖）。
结果：61例患者纳入分析。无重大并发症或围手术期死亡记录。估计2年OS为76.7%，DSS81.8%和LRRFS50.5%。在多变量分析rpT中，PNI（神经周浸润）和HPV阳性与LRFS显着相关（危害比：T3vsT16.43，PNI是vs无4.19，HPV是vs无2.63）。最后跟进,97%的患者无气管导管,而93%的患者无胃造口术。
结论：经口机器人抢救手术是对受rOPSCC影响的特定患者的成功治疗，因为它具有良好的肿瘤学和功能预后。
