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

Authors
 Andrea Costantino  ;  Piero Giuseppe Meliante  ;  Claudio Sampieri  ;  Kyuin Lee  ;  Massimo Ralli  ;  Marco De Vincentiis  ;  Armando De Virgilio  ;  Se-Heon Kim 
Citation
 EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY, Vol.280(10) : 4649-4655, 2023-10 
Journal Title
EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY
ISSN
 0937-4477 
Issue Date
2023-10
MeSH
Carcinoma, Squamous Cell* / drug therapy ; Carcinoma, Squamous Cell* / surgery ; Head and Neck Neoplasms* / etiology ; Humans ; Neoadjuvant Therapy ; Neoplasm Recurrence, Local / etiology ; Oropharyngeal Neoplasms* / pathology ; Pharyngeal Neoplasms* / surgery ; Retrospective Studies ; Robotic Surgical Procedures* / methods ; Treatment Outcome
Keywords
Head and neck neoplasm ; Induction chemotherapy ; Neoadjuvant chemotherapy ; Posterior pharyngeal wall ; Robotic surgery ; Squamous cell carcinoma
Abstract
BackgroundThe 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).MethodsA 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.ResultsEstimated 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.ConclusionsThe 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.
Full Text
https://link.springer.com/article/10.1007/s00405-023-08070-1
DOI
10.1007/s00405-023-08070-1
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Se Heon(김세헌)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/199342
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