Skip to main content
SpringerLink
Log in

Funktionelle Ergebnisse nach chirurgischer Therapie von Oropharynxkarzinomen

Functional outcomes after surgical treatment of oropharyngeal carcinomas

  • Leitthema
  • Published:
HNO Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Das primäre Ziel der chirurgischen Resektion von Karzinomen im Bereich des Oropharynx (OPSCC) ist die sichere R0-Resektion. Die Ausdehnung des Primärtumors ist hierbei ausschlaggebend für den zu wählenden Zugangsweg, der so klein wie möglich, jedoch so radikal wie nötig ausfallen sollte. Bisher existieren keine prospektiven vergleichenden Studien, die das funktionelle Ergebnis in Abhängigkeit vom chirurgischen Zugangsweg verglichen hätten.

Material und Methoden

Zur Beurteilung des funktionellen Ergebnisses nach verschiedenen chirurgischen Therapieansätzen in der Behandlung des OPSCC wurde eine selektive Literaturrecherche für den Zeitraum vom 01.01.2000 bis 31.12.2019 durchgeführt. Hierbei sollten Arbeiten identifiziert werden, die das funktionelle Ergebnis von transoralen Zugängen, roboterunterstützten transoralen Resektionen (TORS) sowie der chirurgischen Resektion über Pharyngotomien bzw. transmandibulären Zugängen untersuchten.

Ergebnisse

Zunächst wurden verschiedene Messgrößen identifiziert, mit denen eine subjektive und objektive Bewertung von Einschränkungen des Schluckens und des Sprechens möglich ist. Für alle chirurgischen Zugangswege wurden Arbeiten identifiziert, die funktionelle Aspekte des jeweiligen Zugangs untersuchten, jedoch liegen keine direkten Vergleiche zwischen den einzelnen Zugängen vor.

Schlussfolgerung

Für die Resektion von Oropharynxkarzinomen stehen unterschiedliche chirurgische Zugangswege zur Verfügung, die jeweils hinsichtlich ihres onkologischen und funktionellen Ergebnisses in verschiedenen Studien untersucht wurden.

Abstract

Introduction

The primary goal of surgical resection of oropharyngeal carcinoma (OPSCC) is an R0 resection. The extension of the primary tumor is decisive for selection of access route, which should be as circumscribed as possible but as radical as necessary. To date, there are no prospective comparative studies that compared functional outcome in terms of surgical access route.

Materials and methods

A selective literature search was carried out for the period from 01/01/2000 to 12/31/2019 to assess the functional result after different surgical approaches in the treatment of OPSCC. The search strategy aimed to identify publications that investigated the functional result of transoral approaches, robot-assisted transoral resections (TORS), and surgical resection using pharyngotomies or transmandibular approaches.

Results

Various measures were identified which enable subjective and objective assessment of swallowing and speaking restrictions. For all surgical access routes, studies were identified that examined the functional aspects of the respective access, but there are no direct comparisons between the individual approaches.

Conclusion

There are various surgical approaches available for resection of OPSCC, each of which has been examined in various studies with regard to its oncological and functional results.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. Parkin DM, Bray F, Ferlay J, Pisani P (2005) Global cancer statistics, 2002. CA Cancer J Clin 55:74–108

    Article  Google Scholar 

  2. Rodin D, Caulley L, Burger E et al (2017) Cost-effectiveness analysis of radiation therapy versus transoral robotic surgery for oropharyngeal squamous cell carcinoma. Int J Radiat Oncol Biol Phys 97:709–717

    Article  Google Scholar 

  3. Chaturvedi AK, Engels EA, Anderson WF, Gillison ML (2008) Incidence trends for human papillomavirus-related and -unrelated oral squamous cell carcinomas in the United States. J Clin Oncol 26:612–619

    Article  Google Scholar 

  4. Patterson JM, Hildreth A, McColl E, Carding PN, Hamilton D, Wilson JA (2011) The clinical application of the 100 mL water swallow test in head and neck cancer. Oral Oncol 47:180–184

    Article  Google Scholar 

  5. Keitel W, Spieler C (1989) The Saxon test for objective assessment of xerostomia. A contribution to the diagnosis of Sjögren’s syndrome. Z Gesamte Inn Med 44:340–341

    CAS  PubMed  Google Scholar 

  6. Bjordal K, Kaasa S (1992) Psychometric validation of the EORTC Core Quality of Life Questionnaire, 30-item version and a diagnosis-specific module for head and neck cancer patients. Acta Oncol 31:311–321

    Article  CAS  Google Scholar 

  7. Eisbruch A, Kim HM, Terrell JE, Marsh LH, Dawson LA, Ship JA (2001) Xerostomia and its predictors following parotid-sparing irradiation of head-and-neck cancer. Int J Radiat Oncol Biol Phys 50:695–704

    Article  CAS  Google Scholar 

  8. Chen AY, Frankowski R, Bishop-Leone J et al (2001) The development and validation of a dysphagia-specific quality-of-life questionnaire for patients with head and neck cancer: the M. D. Anderson dysphagia inventory. Arch Otolaryngol Head Neck Surg 127:870–876

    CAS  PubMed  Google Scholar 

  9. Wilson JA, Carding PN, Patterson JM (2011) Dysphagia after nonsurgical head and neck cancer treatment: patients’ perspectives. Otolaryngol Head Neck Surg 145:767–771

    Article  Google Scholar 

  10. Moore EJ, Olsen KD, Kasperbauer JL (2009) Transoral robotic surgery for oropharyngeal squamous cell carcinoma: a prospective study of feasibility and functional outcomes. Laryngoscope 119:2156–2164

    Article  Google Scholar 

  11. Genden EM, Kotz T, Tong CC et al (2011) Transoral robotic resection and reconstruction for head and neck cancer. Laryngoscope 121:1668–1674

    Article  Google Scholar 

  12. List MA, Ritter-Sterr C, Lansky SB (1990) A performance status scale for head and neck cancer patients. Cancer 66:564–569

    Article  CAS  Google Scholar 

  13. Sethia R, Yumusakhuylu AC, Ozbay I et al (2018) Quality of life outcomes of transoral robotic surgery with or without adjuvant therapy for oropharyngeal cancer. Laryngoscope 128:403–411

    Article  Google Scholar 

  14. Rinkel RN, Verdonck-de Leeuw IM, van Reij EJ, Aaronson NK, Leemans CR (2008) Speech Handicap Index in patients with oral and pharyngeal cancer: better understanding of patients’ complaints. Head Neck 30:868–874

    Article  Google Scholar 

  15. Hoffmann TK, Schuler PJ, Bankfalvi A et al (2014) Comparative analysis of resection tools suited for transoral robot-assisted surgery. Eur Arch Otorhinolaryngol 271:1207–1213

    Article  Google Scholar 

  16. Hofauer B, Knopf A, Strassen U et al (2020) Radiofrequency resection in oral and oropharyngeal tumor surgery. Auris Nasus Larynx 47:148–153

    Article  Google Scholar 

  17. Weiss BG, Ihler F, Anczykowski MZ et al (2019) Transoral laser microsurgery for treatment of oropharyngeal cancer in 368 patients. Head Neck 41:3144–3158

    Article  Google Scholar 

  18. Williams CE, Kinshuck AJ, Derbyshire SG et al (2014) Transoral laser resection versus lip-split mandibulotomy in the management of oropharyngeal squamous cell carcinoma (OPSCC): a case match study. Eur Arch Otorhinolaryngol 271:367–372

    Article  CAS  Google Scholar 

  19. Golusiński W, Golusińska-Kardach E (2019) Current role of surgery in the management of oropharyngeal cancer. Front Oncol 9:388

    Article  Google Scholar 

  20. Stelmes JJ, Gregoire V, Poorten VV et al (2019) Organ preservation and late functional outcome in oropharyngeal carcinoma: rationale of EORTC 1420, the “best of” trial. Front Oncol 9:999

    Article  Google Scholar 

  21. Kelly K, Johnson-Obaseki S, Lumingu J, Corsten M (2014) Oncologic, functional and surgical outcomes of primary transoral robotic surgery for early squamous cell cancer of the oropharynx: a systematic review. Oral Oncol 50:696–703

    Article  Google Scholar 

  22. Nichols AC, Theurer J, Prisman E et al (2019) Radiotherapy versus transoral robotic surgery and neck dissection for oropharyngeal squamous cell carcinoma (ORATOR): an open-label, phase 2, randomised trial. Lancet Oncol 20:1349–1359

    Article  CAS  Google Scholar 

  23. Leonhardt FD, Quon H, Abrahão M, O’Malley BW, Weinstein GS (2012) Transoral robotic surgery for oropharyngeal carcinoma and its impact on patient-reported quality of life and function. Head Neck 34:146–154

    Article  Google Scholar 

  24. Benazzo M, Canzi P, Mauramati S et al (2019) Transoral robot-assisted surgery in supraglottic and oropharyngeal squamous cell carcinoma: laser versus monopolar electrocautery. J Clin Med 8(12):2166

    Article  CAS  Google Scholar 

  25. Remmert C, Mansour N, Hofauer B et al (2017) Pharyngotomy in head and neck squamous cell carcinoma: functional and oncological aspects. Acta Otolaryngol 137:1281–1287

    Article  Google Scholar 

  26. Laccourreye O, Hans S, Ménard M, Garcia D, Brasnu D, Holsinger FC (2005) Transoral lateral oropharyngectomy for squamous cell carcinoma of the tonsillar region: II. An analysis of the incidence, related variables, and consequences of local recurrence. Arch Otolaryngol Head Neck Surg 131:592–599

    Article  Google Scholar 

  27. Laccourreye O, Benito J, Menard M, Garcia D, Malinvaud D, Holsinger C (2013) Lateral pharyngotomy for selected invasive squamous cell carcinoma of the lateral oropharynx—part I: How. Laryngoscope 123:2712–2717

    Article  Google Scholar 

  28. Knopf A, Mansour N, Hofauer B et al (2020) Functional outcome after transmandibular resection and primary chemoradiation in advanced HSCC

    Google Scholar 

  29. Barata LF, de Carvalho GB, Carrara-de Angelis E, de Faria JC, Kowalski LP (2013) Swallowing, speech and quality of life in patients undergoing resection of soft palate. Eur Arch Otorhinolaryngol 270:305–312

    Article  Google Scholar 

  30. Marzouki HZ, Biron VL, Dziegielewski PT et al (2018) The impact of human papillomavirus (HPV) status on functional outcomes and quality of life (QOL) after surgical treatment of oropharyngeal carcinoma with free-flap reconstruction. J Otolaryngol Head Neck Surg 47:58

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinik Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland

    B. Hofauer, N. Mansour, C. Becker, M. C. Ketterer & A. Knopf

Authors
  1. B. Hofauer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. N. Mansour
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Becker
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. C. Ketterer
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. Knopf
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to B. Hofauer.

Ethics declarations

Interessenkonflikt

B. Hofauer, N. Mansour, C. Becker, M.C. Ketterer und A. Knopf geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hofauer, B., Mansour, N., Becker, C. et al. Funktionelle Ergebnisse nach chirurgischer Therapie von Oropharynxkarzinomen. HNO 69, 95–100 (2021). https://doi.org/10.1007/s00106-020-00887-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00106-020-00887-0

Schlüsselwörter

Keywords

Search

Navigation