Transoral laser microsurgery vs. transoral robotic surgery for the resection of oropharyngeal squamous cell carcinoma

Introduction Transoral robotic surgery (TORS) has been attributed to significant advances in the treatment of oropharyngeal cancer (OPSCC) since its first description in 2007. Especially in T1/T2 tumors involving the base of the tongue, this method is compared to transoral laser microsurgery (TLM).

Aim: Evaluation of oncological and functional results of OPSCC therapy with TLM and TORS (DaVinci®).

Methods Retrospective analysis of all patients with OPSCC treated with TLM (n = 30) or TORS (n = 24) between April 2003 and May 2018 (follow-up 43 ± 38.3 months).

Results Both groups were homogeneous in terms of TNM and UICC stage (p = 0.818), p16 status (p = 0.671) and type of adjuvant treatment (p = 0.133). There were no significant differences (TORS vs. TLM) in the duration of surgery (276min vs. 250min, p = 0.471), duration of hospitalization (14.9 vs. 16.6 days, p = 0.549), time in intensive care (1.5 vs. 2.4 days, p = 0.80), tracheotomy frequency (43.3 % vs. 45.8 %, p = 0.114), percutaneous endoscopic gastrostomy rate (36.7 % vs. 50 %, p = 0.325), and postoperative bleeding rate (6.7 % vs. 16.7 %, p = 0.245). Local relapses occurred in three and two patients after an average of 35.7 months (TLM) and 26.5 months (TORS), respectively (p = 0.834). Four patients showed distant metastasis after an average of 41.5 months (TLM) and one patient after 13 months (TORS) (p = 0.248). Disease-free survival was 86.7 % and 87.5 %, respectively (Kaplan-Maier, p = 0.833).

Conclusion TLM and TORS achieved equivalent oncological and functional results associated with comparable perioperative risks.

Poster-PDF A-1201.PDF

Publication History

Article published online:
10 June 2020