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Transoral robotic surgery for squamous cell carcinomas of the posterior pharyngeal wall

  • Head and Neck
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Abstract

Posterior pharyngeal wall squamous cell carcinomas (SCCs) are rare and have an associated poor prognosis. Progress in transoral resection techniques, in particular, transoral robotic surgery (TORS), have renewed the role of surgery in their treatment. This article presents the oncological and functional results obtained by the French Group of Head and Neck Robotic Surgery for TORS for posterior pharyngeal wall SCC-curative surgery. This retrospective, multicentre study presents data collected between September 2009 and November 2013 for patients treated with TORS for posterior pharyngeal wall SCCs. Analysis of patient characteristics, tumour and treatment details were completed. Kaplan–Meier analysis was used to calculate overall survival rates and recurrence-free survival rates. Student’s t test and Chi2 test were also calculated. 23 patients were included (mean age of 62 years). 12 patients had a prior HNSCC. Ten patients had pT1 cancers. The overall two-year survival rate was 59%, but 89% for pT1 compared to 28% for pT2-T3 (p = 0.01). It was noted that TORS was simple to perform, but generated significant post-operative dysphagia. Two cases of spondylodiscitis were reported as specific post-operative complications of TORS. In conclusion, TORS is a treatment solution for selected posterior pharyngeal wall SCCs. It provides a possible alternative to medical treatment for early pT1 lesions and is often the only remaining curative solution in patients previously treated with radiotherapy. In cases of bulky resection, or when there is a past medical history of radiotherapy, a tissue reconstruction by forearm free-flap may be indicated.

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Authors and Affiliations

  1. Department of Head and Neck Surgery, University Hospital of Nîmes, Place du Pr R. Debré, 30029, Nîmes, France

    B. Lallemant, M. Lebalch & Q. Bonduelle

  2. Department of Head and Neck Surgery, University Hospital Bretonneau, Tours, France

    S. Moriniere

  3. Department of Head and Neck Surgery, Hospices Civils de Lyon, University Hospital Lyon-Nord, Lyon, France

    P. Ceruse

  4. Department of Head and Neck Surgery, University Hospital Dupuytren, Limoges, France

    K. Aubry

  5. Department of Head and Neck Surgery, AP-HP, Georges Pompidou Hospital, Paris, France

    S. Hans

  6. Department of Head and Neck Surgery, Centre Alexis Vautrin, Nancy, France

    G. Dolivet

  7. Department of Head and Neck Surgery, Nantes University Hospital, Nantes, France

    O. Malard

  8. Department of Head and Neck Surgery, University Hospital Larrey, Toulouse, France

    S. Vergez

Authors
  1. B. Lallemant
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  2. S. Moriniere
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  3. P. Ceruse
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  4. M. Lebalch
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  5. K. Aubry
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  6. S. Hans
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  7. G. Dolivet
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  8. O. Malard
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  9. Q. Bonduelle
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  10. S. Vergez
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Corresponding author

Correspondence to B. Lallemant.

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Funding

This study had no funding.

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All authors declare no conflicts of interests.

Ethical approval

Paper approved by local ethical department. This article does not contain any studies with human/animal participants performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Lallemant, B., Moriniere, S., Ceruse, P. et al. Transoral robotic surgery for squamous cell carcinomas of the posterior pharyngeal wall. Eur Arch Otorhinolaryngol 274, 4211–4216 (2017). https://doi.org/10.1007/s00405-017-4771-9

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  • DOI: https://doi.org/10.1007/s00405-017-4771-9

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