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Neoadjuvant chemotherapy and transoral robotic surgery for the posterior pharyngeal wall carcinoma

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Abstract

Background

The squamous cell carcinoma (SCC) of the posterior pharyngeal wall (PPW) is associated with poor oncological outcomes based on current literature data. We reported the preliminary outcomes of a potential new treatment protocol based on neoadjuvant chemotherapy (NCT) and transoral robotic surgery (TORS).

Methods

A retrospective single-center case series was performed including a total of 20 patients diagnosed with a SCC of the PPW between October 2010 and September 2021. All patients successfully completed TORS with neck dissection after NCT. Adjuvant treatment was performed in the presence of adverse pathologic features. Loco-regional control (LRC), overall survival (OS), and disease-specific survival (DSS) were defined as the time from surgery to tumor recurrence or death, as appropriate. Survival estimates were calculated by Kaplan–Meier analysis. Surgical data and post-operative functional outcomes were also reported.

Results

Estimated 3-year LRC, OS, and DSS rates (95% Confidence interval) were 59.7% (39.7–89.6), 58.6% (38.7–88.8), and 69.4% (49.9–96.6). The median hospital stay was 21 days (IQR 17.0–23.5). Oral diet and decannulation were achieved after a median of 14 days (IQR 12.0–15.0). Feeding tube and tracheostomy dependence after 6 months was observed in 3 (15%) and 2 (10%) patients, respectively.

Conclusions

The use of NCT followed by TORS for PPW SCC treatment appears to have good oncological and functional outcomes for both early and locally advanced cancers. Further randomized trials and site-specific guidelines are needed.

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Availability of data and material

Data and material are available on request.

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Funding

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Author notes

  1. Andrea Costantino and Piero Giuseppe Meliante have contributed equally.

Authors and Affiliations

  1. Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 4, 20090, Pieve Emanuele, MI, Italy

    Andrea Costantino & Armando De Virgilio

  2. Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, MI, Italy

    Andrea Costantino & Armando De Virgilio

  3. Department of Otorhinolaryngology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea

    Andrea Costantino, Piero Giuseppe Meliante, Claudio Sampieri, Kyuin Lee & Se-Heon Kim

  4. Department of Sense Organs, Sapienza University of Rome, Rome, Italy

    Piero Giuseppe Meliante, Massimo Ralli & Marco De Vincentiis

  5. Azienda Ospedaliera Policlinico Umberto I, Viale dell’Università, 33, 00161, Rome, RM, Italy

    Piero Giuseppe Meliante, Massimo Ralli & Marco De Vincentiis

  6. Unit of Otorhinolaryngology-Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy

    Claudio Sampieri

  7. Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy

    Claudio Sampieri

Authors
  1. Andrea Costantino
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  2. Piero Giuseppe Meliante
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  3. Claudio Sampieri
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  4. Kyuin Lee
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  8. Se-Heon Kim
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Corresponding author

Correspondence to Se-Heon Kim.

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Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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The Yonsei University College of Medicine review board approved the retrospective study.

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Patients signed an informed consent for the anonymous collection of data for the purposes of scientific research at the time of hospital admission.

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Costantino, A., Meliante, P.G., Sampieri, C. et al. Neoadjuvant chemotherapy and transoral robotic surgery for the posterior pharyngeal wall carcinoma. Eur Arch Otorhinolaryngol 280, 4649–4655 (2023). https://doi.org/10.1007/s00405-023-08070-1

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