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Transoral robotic surgery-based therapy in patients with stage III-IV oropharyngeal squamous cell carcinoma

Authors
 Young Min Park  ;  Hye Ryun Kim  ;  Byoung Chul Cho  ;  Ki Chang Keum  ;  Nam Hoon Cho  ;  Se-Heon Kim 
Citation
 Oral Oncology, Vol.75 : 16-21, 2017 
Journal Title
 Oral Oncology 
ISSN
 1368-8375 
Issue Date
2017
Keywords
Adjuvant therapy ; Neoadjuvant chemotherapy ; Oropharyngeal cancer ; Transoral robotic surgery
Abstract
OBJECTIVE: TORS-based therapy including chemotherapy or RTx was administered to patients with stage III-IV OPSCC. We analyzed the oncological and functional outcomes of stage III-IV OPSCC patients who underwent TORS-based therapy. MATERIALS AND METHODS: Between May 2008 and May 2016, 80 patients participated in this clinical trial. RESULTS: A negative margin was identified in 66 patients (82.5%) and a positive margin in 14 (17.5%). TNM stages were III in 13 patients (16.3%) and IV in 67 patients (83.8%). Of the patients, 13 received surgery alone, 28 had adjuvant RTx and 39 had adjuvant CCRTx. At last follow-up, 67 patients had no evidence of disease, seven were alive with disease, and six had died. Local recurrence developed in 2 patients and regional recurrence in 10. Five-year overall survival was 88.8%, disease-specific survival was 89.9%, and recurrence-free survival was 78.3%. The 5-year disease-specific survival of OPSCC patients with p16+ disease was 93.2%, which was higher than 89.0% of patients with p16- disease, but the difference was not statically significant. On multivariate analysis, only extranodal extension showed a significant relationship with recurrence-free survival on Cox regression analysis. CONCLUSION: TORS-based therapy showed excellent oncological and functional outcomes for treatment of stage III-IV OPSCC. For advanced T stage OPSCC, clear margins were obtained using TORS-based therapy and patients with clear margins showed good local control. Risk stratification of patients based on pathological information obtained after surgery and decision about additional treatment based on the information helped improve OS and DSS of OPSCC patients.
Full Text
https://www.sciencedirect.com/science/article/pii/S1368837517303214
DOI
10.1016/j.oraloncology.2017.10.014
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
금기창(Keum, Ki Chang) ORCID logo https://orcid.org/0000-0003-4123-7998
김세헌(Kim, Se Heon)
김혜련(Kim, Hye Ryun) ORCID logo https://orcid.org/0000-0002-1842-9070
박영민(Park, Young Min) ORCID logo https://orcid.org/0000-0002-7593-8461
조남훈(Cho, Nam Hoon) ORCID logo https://orcid.org/0000-0002-0045-6441
조병철(Cho, Byoung Chul) ORCID logo https://orcid.org/0000-0002-5562-270X
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/161571
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