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What should we expect from robotic surgery for second primary oropharyngeal cancer?

  • Head and Neck
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Abstract

The outcomes of second primary oropharyngeal cancer (SPOPC) may not be determined by oropharyngeal cancer but from the other index cancer as well. The management of (SPOPC) remains inconclusive and limited. Transoral robotic surgery (TORS) to maximize the functional outcomes without reducing oncologic effect is suggested as the primary treatment for selected oropharyngeal cancer. This study aimed to evaluate the feasibility and outcomes of TORS for the management of SPOPC. Patients who underwent TORS from January 2011 to June 2015 at a tertian referral center in Taiwan were recruited. Loco-regional status, overall survival (OS), disease-specific survival (DSS), and postoperative functional status were evaluated. Fifteen patients received TORS for SPOPC with curative intent, including eleven with tongue-base carcinomas, and four with tonsil carcinomas. One case was terminated because of inadequate exposure and the other 14 cases were completed with negative pathologic margins. Two-year OS and DSS were 53 and 77%, respectively. Patients with SPOPC occurring within 6 months had poorer outcomes (p = 0.044). The median time to feeding-tube removal was 5 days, and one patient had long-term gastric-tube dependence. Patients of age <65 years with synchronous SPOPC and esophageal cancer as the other index cancer were significant worse in oncologic outcomes. We concluded that TORS is a feasible alternative treatment in selected patients with SPOPC. Patients with metachronous T1–2 SPOPC without an esophageal primary can achieve excellent survival after TORS, while TORS can maximize functional preservation with limited destruction in patients with low life expectancy.

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Acknowledgements

We are grateful for contributions by the Head and Neck Cancer Team of Chang Gung Memorial Hospital, Linkou Medical Cancer.

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Authors and Affiliations

  1. Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan

    Tuan-Jen Fang, Li-Ang Lee & Chun-Ta Liao

  2. School of Medicine, Chang Gung University, Taoyuan, Taiwan

    Tuan-Jen Fang, Li-Ang Lee, Bing-Shan Huang, Chien-Yu Lin, Cheng-Lung Hsu, Joseph Tung-Chieh Chang, Tzu-Chen Yen & Chun-Ta Liao

  3. Head and Neck Oncologic Group, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

    Tuan-Jen Fang, Li-Ang Lee, Bing-Shan Huang, Chien-Yu Lin, Cheng-Lung Hsu, Joseph Tung-Chieh Chang, Tzu-Chen Yen & Chun-Ta Liao

  4. Department of Radiation Oncology, Chang Gung Memorial Hospital, Linkou, Taiwan

    Bing-Shan Huang, Chien-Yu Lin & Joseph Tung-Chieh Chang

  5. Department of Medical Oncology, Chang Gung Memorial Hospital, Linkou, Taiwan

    Cheng-Lung Hsu

  6. Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital, Linkou, Taiwan

    Tzu-Chen Yen

  7. Graduate School of Management, Ming Chung University, Taipei, Taiwan

    Hui-Chen Chiang

  8. 5 Fu-Shin Street, Kweishan 333, Taoyuan, Taiwan

    Tuan-Jen Fang

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  1. Tuan-Jen Fang
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Correspondence to Tuan-Jen Fang.

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Funding

This study was funded by Grants CMRPG 3D1413 from the Chang Gung Medical Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors have no other funding, or financial relationships to disclose.

Conflict of interest

All authors declare that he/she has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

The protocol of the study was approved by the Institutional Review Board (IRB No: 201601215B0) of Chang Gung Medical Foundation on 2016/10/18. Informed consent was not required.

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Fang, TJ., Lee, LA., Huang, BS. et al. What should we expect from robotic surgery for second primary oropharyngeal cancer?. Eur Arch Otorhinolaryngol 274, 3161–3168 (2017). https://doi.org/10.1007/s00405-017-4594-8

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  • DOI: https://doi.org/10.1007/s00405-017-4594-8

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