Use of transoral robotic surgery (TORS) is associated with a lower gastrostomy prevalence without affecting survival, in contrast with nonsurgical therapy, among patients with oropharyngeal squamous cell carcinoma (OPSCC), a study published in JAMA Otolaryngology–Head & Neck Surgery has shown.1
Many treatments of OPSCC are associated with significant morbidity. Although TORS is 1 strategy for the treatment of OPSCC, there are limited data contrasting outcomes between patients who received TORS-based therapy and nonsurgical therapy. Researchers contrasted survival and gastrostomy prevalence among these patients in a retrospective, matched-cohort study.
Investigators enrolled 39 patients with OPSCC who underwent TORS and 88 matched patients who received nonsurgical therapy. All patients were treated at the University of Washington and University of Minnesota tertiary care medical centers between 2005 and 2013. Patients in the TORS group were more likely to have p16-positive tumors, in contrast with those in the nonsurgical group.
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After adjusting for multiple factors, results showed no statistically significant difference in disease-free survival between the groups (hazard ratio, 0.22; 95% CI, 0.04-1.36; P = .10); it was found, however, that patients who underwent TORS-based therapy had a lower prevalence of gastrostomy tube after treatment (relative risk, 0.43; 95% CI, 0.27-0.68; P < .001). Gastrostomy prevalence decreased from month 3 to month 12 in both treatment groups.
The findings suggest that TORS is a promising strategy for improving swallowing function in patients with OPSCC, without compromising disease-free survival.
1. Sharma A, Patel S, Baik F, et al. Survival and gastrostomy prevalence in patients with oropharyngeal cancer treated with transoral robotic surgery vs chemoradiotherapy. JAMA Otolaryngol Head Neck Surg. 2016 Jun 23. doi: 10.1001/jamaoto.2016.1106 [Epub ahead of print]