Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Häufige urologisch-sexualmedizinische Themen in der Praxis sind das Thema des MMW-Webinars am 5. Juni von 17.30 bis 19 Uhr. Konkret geht es um die Frage, wann bei Harnwegsinfektionen auf Antibiotika verzichtet werden kann, und um ein Update zur Therapie von Libido- und Potenzstörungen des Mannes. Der dritte Vortrag behandelt sexuell übertragbare Krankheiten. Stellen Sie Ihre Fragen an die Experten und sammeln Sie 2 CME-Punkte. Jetzt gleich anmelden!
Erweiterte Suche
Anmelden
nach oben
Current Oncology Reports
Erschienen in: Current Oncology Reports 3/2015

01.03.2015 | Head and Neck Cancers (E Hanna, Section Editor)

The Role of Transoral Robotic Surgery in the Management of Oropharyngeal Squamous Cell Carcinoma: a Current Review

verfasst von: E. Ritter Sansoni, Neil D. Gross

Erschienen in: Current Oncology Reports | Ausgabe 3/2015

Einloggen, um Zugang zu erhalten

Abstract

The incidence of oropharyngeal squamous cell carcinoma (OPSCC) is increasing in the USA despite a decline in traditional risk factors. This trend is attributed to human papillomavirus (HPV)-associated malignancies and is particularly notable in a younger patient demographic with fewer comorbid diseases and longer life expectancies. Therefore, both oncologic and functional outcomes are important to consider when managing OPSCC in the modern era. The historical management of OPSCC was typically surgical, but traditional open approaches resulted in significant morbidity. As the paradigm shifted, organ-preserving treatment regimens, namely, radiotherapy (RT) and chemoradiation (CRT), replaced surgery as the primary treatment modality. However, these treatment strategies are not without risk of significant sequelae and functional impairment. Transoral robotic surgery (TORS) is a minimally invasive surgical approach that offers surgical access to the oropharynx without the morbidity of open procedures while achieving excellent oncologic and functional outcomes. The appropriate application of this new technology is still being investigated but the current literature supports TORS as a viable option in the management of OPSCC.
Literatur
1.
Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014. CA Cancer J Clin. 2014;64(1):9–29.CrossRefPubMed
2.
Stein AP, Saha S, Yu M, Kimple RJ, Lambert PF. Prevalence of human papillomavirus in oropharyngeal squamous cell carcinoma in the united states across time. Chem Res Toxicol. 2014;27(4):462–9.CrossRefPubMed
3.
Chaturvedi AK, Engels EA, Anderson WF, Gillison ML. Incidence trends for human papillomavirus-related and -unrelated oral squamous cell carcinomas in the United States. J Clin Oncol. 2008;26(4):612–9.CrossRefPubMed
4.
Panwar A, Batra R, Lydiatt WM, Ganti AK. Human papilloma virus positive oropharyngeal squamous cell carcinoma: a growing epidemic. Cancer Treat Rev. 2014;40(2):215–9.CrossRefPubMed
5.
Pytynia KB, Dahlstrom KR, Sturgis EM. Epidemiology of HPV-associated oropharyngeal cancer. Oral Oncol. 2014;50(5):380–6.CrossRefPubMed
6.
Gayar OH, Ruterbusch JJ, Elshaikh M, Cote M, Ghanem T, Hall F, et al. Oropharyngeal carcinoma in young adults: an alarming national trend. Otolaryngol Head Neck Surg. 2014;150(4):594–601.CrossRefPubMed
7.
Benson E, Li R, Eisele D, Fakhry C. The clinical impact of HPV tumor status upon head and neck squamous cell carcinomas. Oral Oncol. 2014;50(6):565–74.CrossRefPubMed
8.
Ang KK, Harris J, Wheeler R, Weber R, Rosenthal DI, Nguyen-Tan PF, et al. Human papillomavirus and survival of patients with oropharyngeal cancer. N Engl J Med. 2010;363(1):24–35.CrossRefPubMedCentralPubMed
9.
Brickman D, Gross ND. Robotic approaches to the pharynx: tonsil cancer. Otolaryngol Clin North Am. 2014;47(3):359–72.CrossRefPubMed
10.
Pfister DG, Harrison LB, Strong EW, Shah JP, Spiro RW, Kraus DH, et al. Organ-function preservation in advanced oropharynx cancer: results with induction chemotherapy and radiation. J Clin Oncol. 1995;13(3):671–80.PubMed
11.
Wendt TG. Hazards and risks in oncology: radiation oncology. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2013;12:Doc03.PubMedCentralPubMed
12.
Forastiere AA, Goepfert H, Maor M, Pajak TF, Weber R, Morrison W, et al. Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. N Engl J Med. 2003 11/27; 2014/08;349(22):2091-8.
13.
Steiner W, Fierek O, Ambrosch P, Hommerich CP, Kron M. Transoral laser microsurgery for squamous cell carcinoma of the base of the tongue. Arch Otolaryngol Head Neck Surg. 2003;129(1):36–43.CrossRefPubMed
14.
15.
Moore EJ, Hinni ML. Critical review: transoral laser microsurgery and robotic-assisted surgery for oropharynx cancer including human papillomavirus–related cancer. Int J Radiat Oncol*Biol*Phys. 2013 4/1;85(5):1163-7.
16.
Hockstein NG, Nolan JP, O’Malley BW, Woo YJ. Robotic microlaryngeal surgery: a technical feasibility study using the daVinci surgical robot and an airway mannequin. Laryngoscope. 2005;115(5):780–5.CrossRefPubMed
17.
O’Malley Jr BW, Weinstein GS, Hockstein NG. Transoral robotic surgery (TORS): glottic microsurgery in a canine model. J Voice. 2006;20(2):263–8.CrossRefPubMed
18.
O’Malley BW, Weinstein GS, Snyder W, Hockstein NG. Transoral robotic surgery (TORS) for base of tongue neoplasms. Laryngoscope. 2006;116(8):1465–72.CrossRefPubMed
19.
Weinstein GS, Quon H, O’Malley BW, Kim GG, Cohen MA. Selective neck dissection and deintensified postoperative radiation and chemotherapy for oropharyngeal cancer: a subset analysis of the University of Pennsylvania transoral robotic surgery trial. Laryngoscope. 2010;120(9):1749–55.CrossRefPubMed
20.
Weinstein GS, O’Malley Jr BW, Cohen MA, Quon H. Transoral robotic surgery for advanced oropharyngeal carcinoma. Arch Otolaryngol Head Neck Surg. 2010;136(11):1079–85.CrossRefPubMed
21.
Weinstein GS, O’Malley Jr BW, Snyder W, Sherman E, Quon H. Transoral robotic surgery: radical tonsillectomy. Archiv Otolaryngol Head Neck Surg. 2007;133(12):1220–6.CrossRef
22.
Gunn GB, Debnam JM, Fuller CD, Morrison WH, Frank SJ, Beadle BM, et al. The impact of radiographic retropharyngeal adenopathy in oropharyngeal cancer. Cancer. 2013;119(17):3162–9.CrossRefPubMedCentralPubMed
23.
Dirix P, Nuyts S, Bussels B, Hermans R, Van den Bogaert W. Prognostic influence of retropharyngeal lymph node metastasis in squamous cell carcinoma of the oropharynx. Int J Radiat Oncol*Biol*Phys. 2006 7/1;65(3):739-44.
24.
Byeon HK, Duvvuri U, Kim WS, Park YM, Hong HJ, Koh YW, et al. Transoral robotic retropharyngeal lymph node dissection with or without lateral oropharyngectomy. J Craniofac Surg. 2013;24(4):1156–61.CrossRefPubMed
25.
Moore MW, Jantharapattana K, Williams MD, Grant DG, Selber JC, Holsinger FC. Retropharyngeal lymphadenectomy with transoral robotic surgery for papillary thyroid cancer. J Robotic Surg. 2011;5:221–6.CrossRef
26.
Abuzeid WM, Bradford CR, Divi V. Transoral robotic biopsy of the tongue base: a novel paradigm in the evaluation of unknown primary tumors of the head and neck. Head Neck. 2013;35(4):E126–30.CrossRefPubMed
27.
Mehta V, Johnson P, Tassler A, Kim S, Ferris RL, Nance M, et al. A new paradigm for the diagnosis and management of unknown primary tumors of the head and neck: a role for transoral robotic surgery. Laryngoscope. 2013;123(1):146–51.CrossRefPubMed
28.•
Patel SA, Magnuson J, Holsinger F, et al. Robotic surgery for primary head and neck squamous cell carcinoma of unknown site. JAMA Otolaryngol Head Neck Surg. 2013;139(11):1203–11. Retrospective, multi-institution case series that evaluated the utility of TORS for the work-up of an unknown primary tumor site. 47 patients were included and the primary tumor was identified by TORS 72.3% of the time. The primary site was in the base of tongue 58.8% of the time and was located in the palatine tonsil 38.2% of the time. The authors discuss the benefit of being able to simultaneously diagnose and treat an unknown primary using TORS.CrossRefPubMed
29.
Cianchetti M, Mancuso AA, Amdur RJ, Werning JW, Kirwan J, Morris CG, et al. Diagnostic evaluation of squamous cell carcinoma metastatic to cervical lymph nodes from an unknown head and neck primary site. Laryngoscope. 2009;119(12):2348–54.CrossRefPubMed
30.•
Ford SE, Brandwein-Gensler M, Carroll WR, Rosenthal EL, Magnuson JS. Transoral robotic versus open surgical approaches to oropharyngeal squamous cell carcinoma by human papillomavirus status. Otolaryngol Head Neck Surg. 2014. Retrospective review evaluating 130 patients with OPSCC treated at UAB with either an open approach or TORS plus adjuvant therapies as indicated. The data demonstrated no sacrifice of oncologic results regardless of HPV status.
31.
Lawson JD, Otto K, Chen A, Shin DM, Davis L, Johnstone PA. Concurrent platinum-based chemotherapy and simultaneous modulated accelerated radiation therapy for locally advanced squamous cell carcinoma of the tongue base. Head Neck. 2008;30(3):327–35.CrossRefPubMed
32.
de Arruda FF, Puri DR, Zhung J, Narayana A, Wolden S, Hunt M, et al. Intensity-modulated radiation therapy for the treatment of oropharyngeal carcinoma: the Memorial Sloan-Kettering Cancer Center experience. Int J Radiat Oncol Biol Phys. 2006;64(2):363–73.CrossRefPubMed
33.•
Weinstein GS, Quon H, Newman H, et al. Transoral robotic surgery alone for oropharyngeal cancer: an analysis of local control. Archiv Otolaryngol Head Neck Surg. 2012;138(7):628–34. A prospective observational study of 30 patients treated at Penn with TORS alone demonstrated excellent local control after obtaining negative surgical margins. Mean follow-up was 2.7 years (range, 1.5-5.1 years) and local failure occurred in one patient (3%). This study provides further evidence supporting the possibility of de-intensifying adjuvant therapies.CrossRef
34.
Hurtuk A, Agrawal A, Old M, Teknos TN, Ozer E. Outcomes of transoral robotic surgery: a preliminary clinical experience. Otolaryngol Head Neck Surg. 2011;145(2):248–53.CrossRefPubMedCentralPubMed
35.
Iseli TA, Kulbersh BD, Iseli CE, Carroll WR, Rosenthal EL, Magnuson JS. Functional outcomes after transoral robotic surgery for head and neck cancer. Otolaryngol Head Neck Surg. 2009;141(2):166–71.CrossRefPubMed
36.
Al-Khudari S, Bendix S, Lindholm J, Simmerman E, Hall F, Ghanem T. Gastrostomy tube use after transoral robotic surgery for oropharyngeal cancer. ISRN Otolaryngol. 2013;2013:190364.CrossRefPubMedCentralPubMed
37.
Chen AY, Frankowski R, Bishop-Leone J, et al. 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. 2001;127(7):870–6.PubMed
38.
Sinclair CF, McColloch NL, Carroll WR, Rosenthal EL, Desmond RA, Magnuson J. Patient-perceived and objective functional outcomes following transoral robotic surgery for early oropharyngeal carcinoma. Arch Otolaryngol Head Neck Surg. 2011;137(11):1112–6.CrossRefPubMed
39.
Gillespie M, Brodsky MB, Day TA, Sharma AK, Lee F, Martin-Harris B. Laryngeal penetration and aspiration during swallowing after the treatment of advanced oropharyngeal cancer. Arch Otolaryngol Head Neck Surg. 2005;131(7):615–9.CrossRefPubMed
40.
More YI, Tsue TT, Girod DA, et al. Functional swallowing outcomes following transoral robotic surgery vs primary chemoradiotherapy in patients with advanced-stage oropharynx and supraglottis cancers. JAMA Otolaryngol Head Neck Surg. 2013;139(1):43–8.CrossRefPubMed
41.
Dziegielewski PT, Teknos TN, Durmus K, et al. Transoral robotic surgery for oropharyngeal cancer: long-term quality of life and functional outcomes. JAMA Otolaryngol Head Neck Surg. 2013;139(11):1099–108.CrossRefPubMedCentralPubMed
42.
Levendag PC, Teguh DN, Voet P, van der Est H, Noever I, de Kruijf WJM, et al. Dysphagia disorders in patients with cancer of the oropharynx are significantly affected by the radiation therapy dose to the superior and middle constrictor muscle: a dose-effect relationship. Radiother Oncol. 2007;85(1):64–73.CrossRefPubMed
43.••
Weinstein GS, O’Malley BW, Magnuson JS, Carroll WR, Olsen KD, Daio L, et al. Transoral robotic surgery: a multicenter study to assess feasibility, safety, and surgical margins. Laryngoscope. 2012;122(8):1701–7. Multicenter study including 177 patients with malignancies of the head and neck demonstrated a low rate of positive surgical margins (4.3%), serious complications (2.3%) and functional outcomes. The authors conclude that TORS should play a significant role in the multidisciplinary management of head and neck malignancies.CrossRefPubMed
44.
Gourin CG, Forastiere AA, Sanguineti G, Marur S, Koch WM, Bristow RE. Impact of surgeon and hospital volume on short-term outcomes and cost of oropharyngeal cancer surgical care. Laryngoscope. 2011;121(4):746–52.CrossRefPubMedCentralPubMed
45.
Chia SH, Gross ND, Richmon JD. Surgeon experience and complications with transoral robotic surgery (TORS). Otolaryngol Head Neck Surg. 2013;149(6):885–92.CrossRefPubMed
46.
Asher SA, White HN, Kejner AE, Rosenthal EL, Carroll WR, Magnuson JS. Hemorrhage after transoral robotic-assisted surgery. Otolaryngol Head Neck Surg. 2013;149(1):112–7.CrossRefPubMed
47.
Pollei TR, Hinni ML, Moore EJ, et al. Analysis of postoperative bleeding and risk factors in transoral surgery of the oropharynx. JAMA Otolaryngol Head Neck Surg. 2013;139(11):1212–8.CrossRefPubMed
48.
White HN, Moore EJ, Rosenthal EL, Carroll WR, Olsen KD, Desmond RA, et al. Transoral robotic-assisted surgery for head and neck squamous cell carcinoma: one- and 2-year survival analysis. Arch Otolaryngol Head Neck Surg. 2010;136(12):1248–52.CrossRefPubMed
49.
Cohen MA, Weinstein GS, O’Malley BW, Feldman M, Quon H. Transoral robotic surgery and human papillomavirus status: oncologic results. Head Neck. 2011;33(4):573–80.CrossRefPubMed
50.
Moore EJ, Olsen SM, Laborde RR, García JJ, Walsh FJ, Price DL, et al. Long-term functional and oncologic results of transoral robotic surgery for oropharyngeal squamous cell carcinoma. Mayo Clin Proc. 2012;87(3):219–25.CrossRefPubMedCentralPubMed
51.
Hurtuk AM, Marcinow A, Agrawal A, Old M, Teknos TN, Ozer E. Quality-of-life outcomes in transoral robotic surgery. Otolaryngol Head Neck Surg. 2012;146(1):68–73.CrossRefPubMedCentralPubMed
52.
Moore EJ, Olsen KD, Kasperbauer JL. Transoral robotic surgery for oropharyngeal squamous cell carcinoma: a prospective study of feasibility and functional outcomes. Laryngoscope. 2009;119(11):2156–64.CrossRefPubMed
53.
Olsen SM, Moore EJ, Laborde RR, Garcia JJ, Janus JR, Price DL, et al. Transoral surgery alone for human-papillomavirus-associated oropharyngeal squamous cell carcinoma. Ear Nose Throat J. 2013;92(2):76–83.PubMed
Metadaten
Titel
The Role of Transoral Robotic Surgery in the Management of Oropharyngeal Squamous Cell Carcinoma: a Current Review
verfasst von
E. Ritter Sansoni
Neil D. Gross
Publikationsdatum
01.03.2015
Verlag
Springer US
Erschienen in
Current Oncology Reports / Ausgabe 3/2015
Print ISSN: 1523-3790
Elektronische ISSN: 1534-6269
DOI
https://doi.org/10.1007/s11912-014-0432-y

Weitere Artikel der Ausgabe 3/2015

Current Oncology Reports 3/2015 Zur Ausgabe

Pediatric Oncology (S Epelman, Section Editor)

Pediatric Brainstem Gliomas: New Understanding Leads to Potential New Treatments for Two Very Different Tumors

Breast Cancer (B Overmoyer, Section Editor)

Metaplastic Breast Cancer: Clinical Overview and Molecular Aberrations for Potential Targeted Therapy

Gastrointestinal Cancers (BG Czito, Section Editor)

The Neoadjuvant Treatment of Rectal Cancer: A Review

Head and Neck Cancers (E Hanna, Section Editor)

Surgical Salvage of Recurrent Nasopharyngeal Carcinoma

Gynecologic Cancers (NS Reed, Section Editor)

Long-Term Experience with (Laterally) Extended Endopelvic Resection (LEER) in Relapsed Pelvic Malignancies

Neu im Fachgebiet Onkologie

Erhöhtes Risiko fürs Herz unter Checkpointhemmer-Therapie

28.05.2024 Nebenwirkungen der Krebstherapie Nachrichten

Kardiotoxische Nebenwirkungen einer Therapie mit Immuncheckpointhemmern mögen selten sein – wenn sie aber auftreten, wird es für Patienten oft lebensgefährlich. Voruntersuchung und Monitoring sind daher obligat.

Costims – das nächste heiße Ding in der Krebstherapie?

28.05.2024 Onkologische Immuntherapie Nachrichten

„Kalte“ Tumoren werden heiß – CD28-kostimulatorische Antikörper sollen dies ermöglichen. Am besten könnten diese in Kombination mit BiTEs und Checkpointhemmern wirken. Erste klinische Studien laufen bereits.

Perioperative Checkpointhemmer-Therapie verbessert NSCLC-Prognose

28.05.2024 NSCLC Nachrichten

Eine perioperative Therapie mit Nivolumab reduziert das Risiko für Rezidive und Todesfälle bei operablem NSCLC im Vergleich zu einer alleinigen neoadjuvanten Chemotherapie um über 40%. Darauf deuten die Resultate der Phase-3-Studie CheckMate 77T.

Positiver FIT: Die Ursache liegt nicht immer im Dickdarm

27.05.2024 Blut im Stuhl Nachrichten

Immunchemischer Stuhltest positiv, Koloskopie negativ – in solchen Fällen kann die Blutungsquelle auch weiter proximal sitzen. Ein Forschungsteam hat nachgesehen, wie häufig und in welchen Lokalisationen das der Fall ist.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise