Better outcomes with transoroal robotic surgery alone in OPSCC

(HealthDay)—For patients with oropharyngeal squamous cell carcinoma (OPSCC), transoral robotic surgery (TORS) alone is associated with improved outcomes versus TORS followed by adjuvant treatment, according to a study published online Oct. 26 in JAMA Otolaryngology—Head & Neck Surgery.

Virginie Achim, M.D., from Oregon Health and Science University in Portland, and colleagues compared functional speech, swallowing, and quality-of-life outcomes for those undergoing TORS only and those undergoing TORS and adjuvant radiotherapy (TORS+RT) or TORS and chemoradiotherapy (TORS+CRT). Data were included for 74 patients undergoing TORS for initial treatment of OPSCC and were collected at baseline, postoperatively, and at short- and long-term follow-up.

The researchers found that the response rates were 86, 88, and 86 percent postoperatively and at short- and long-term follow-up, respectively. There was a significant worsening in pain and all swallowing-related measures postoperatively in all three treatment groups. The improvement in postoperative dysphagia was significantly quicker in the TORS-only group. Weight loss differed between the TORS-only and TORS+RT groups and the TORS-only and TORS+CRT groups in a clinically meaningful way at long-term follow-up (mean differences, −16.1 [95 percent confidence interval, −29.8 to −2.4] and −14.6 [95 percent confidence interval, −29.2 to 0], respectively). The TORS-only group had significantly better scores on the Performance Status Scale-Eating in Public scale and Head and Neck Quality of Life-Eating scale than the TORS+CRT group.

"These findings support the investigation of adjuvant de-escalation therapies to reduce the long-term adverse effects of treatment," the authors write.

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