Neck dissection and trans oral robotic surgery for oropharyngeal squamous cell carcinoma.

Giuseppe Meccariello Antonino Maniaci Giulia Bianchi Giovanni Cammaroto Giannicola Iannella Andrea Catalano Rossella Sgarzani Andrea De Vito Pasquale Capaccio Stefano Pelucchi Claudio Vicini

Auris Nasus Larynx

Otolaryngology and Head-Neck Surgery Unit, Department of Head-Neck Surgeries, Morgagni Pierantoni Hospital, Azienda USL della Romagna, Forlì, Italy.

Published: February 2022

Trans Oral Robotic Surgery (TORS) is assessed for its effectiveness in treating patients with oropharyngeal squamous cell carcinoma, specifically comparing Selective Neck Dissection (SND) and Modified Radical Neck Dissection (MRND).
The study involved 37 patients receiving SND and 18 undergoing MRND, revealing that the regional relapse rate was lower in the SND group (6.1% vs. 18.8%), although the differences in overall survival and disease-free survival rates were not statistically significant.
The findings suggest that SND can be safely performed within the TORS framework, with treatment decisions ideally made by a multidisciplinary tumor board.

Objective: Trans Oral Robotic Surgery (TORS) is a modality in the management of oropharyngeal squamous cell carcinoma(OPSCC). This study was planned to determine whether Selective Neck Dissection (SND) is oncological safe procedure even in patients with lymph node metastases.

Methods: OPSCC patients were divided into Modified Radical Neck Dissection (MRND) and SND groups. The outcome measures were overall survival (OS), disease-free survival (DFS) and regional recurrence free survival (RRFS).

Results: Thirty-seven SNDs and 18 MRNDs were performed. Regional relapse rate was 6.1% in SND group whilst 18.8% in MRND group(p=0.19). The 5-year OS, DFS and RRFS rates' differences were not statistically significant between SND and MRND groups (p=0.40, p=0.42 and p=0.18, respectively). At multivariate analysis, advanced stage impacted the 5-year OS and DFS(HR=9.39, p<0.01 and HR=11.03, p=0.04).

Conclusions: The SND seems to be effective in a TORS framework. The indication should be accurately discussed by the multidisciplinary tumor board.

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http://dx.doi.org/10.1016/j.anl.2021.05.007	DOI Listing

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