Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Otorhinolaryngol. Nov 29, 2024; 11(3): 25-32
Published online Nov 29, 2024. doi: 10.5319/wjo.v11.i3.25
Recurrent oropharyngeal cancer: Analysis of surgical treatment outcomes
Konstantin Ilkaev, Shalva R Gvetadze, Ekaterina A Roshchina, Ruben I Azizyan, Ali M Mudunov, Mikhail V Bolotin, Xin Yang, Denis Larinov
Konstantin Ilkaev, Ruben I Azizyan, Head and Neck Cancer Surgery and Oncology Department, NN Blokhin National Medical Research Center of Oncology, Moscow 115478, Moskva, Russia
Shalva R Gvetadze, Department of Out-Patient, PA Hertzen Moscow Oncology Research Institute-branch of the National Medical Research Radiological Center, Moscow 125284, Moskva, Russia
Shalva R Gvetadze, Department of Surgical Oncology, Russian Scientific Center of Roentgenoradiology, Moscow 117997, Moskva, Russia
Ekaterina A Roshchina, Department of Emergency, University of Mississippi Medical Centre, Jackson, MS 3921, United States
Ali M Mudunov, Department of Oncology, Sechenov First Moscow State Medical University, Moscow 119048, Moskva, Russia
Mikhail V Bolotin, Head & Neck Oncology, NN Blokhin National Medical Research Center of Oncology, Moscow 115478, Moskva, Russia
Xin Yang, Department of Oral and Maxillofacial-Head and Neck Oncology, Hanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Center for Oral Disease, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
Denis Larinov, Radiation Oncology Department, Advanced Care Oncology Center, Dubai 214630, Dubai, United Arab Emirates
Co-first authors: Konstantin Ilkaev and Shalva R Gvetadze.
Author contributions: Ilkaev K, Gvetadze SR, Azizyan RI, and Mudunov AM developed the design of the research and performed the research and the analysis of the data; Roshchina EA, Bolotin MV, Larinov D, and Yang X took part in the clinical data collecting and its analysis; Ilkaev K and Gvetadze SR wrote and edited the manuscript; All the contributing authors have read the text and approved the final copy of the article. Zhao Ilkaev K and Gvetadze SR contributed equally to this work as co-first authors.
Institutional review board statement: The study’s application of clinical data did not require an institutional review board statement.
Informed consent statement: All study participants provided informed written consent prior to study enrollment for the surgical procedure.
Conflict-of-interest statement: The authors of this manuscript certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Konstantin Ilkaev, MD, PhD, Doctor, Research Assistant, Researcher, Head and Neck Cancer Surgery and Oncology Department, NN Blokhin National Medical Research Center of Oncology, No. 23 Kashirskoye Highway, Moscow 115478, Moskva, Russia. dr.ilkaev@gmail.com
Received: February 23, 2024
Revised: September 19, 2024
Accepted: October 28, 2024
Published online: November 29, 2024
Processing time: 278 Days and 20.4 Hours
Abstract
BACKGROUND

The main goal of our research is to introduce transoral robotic surgery and laser resection (TLR) as a considerable way of treating patients with recurrent oropharyngeal malignancies.

AIM

To develop a foundation of minimally invasive transoral surgical technique for patients with oropharyngeal recurrence.

METHODS

This study prospectively and retrospectively included patients with recurrent tumors from 2003 to 2018. Subjects were allocated into two groups: (1) Group I; underwent TLR; and (2) Group II (control); underwent open surgeries of varying volume. Evaluation was done with intraoperative blood loss, postoperative infection incidence, and quality of life using the scale for patients with head and neck tumors known as the Functional Assessment of Cancer Therapy-Head & Neck Scale.

RESULTS

One-hundred and forty one patients were included (103 males and 38 females), in 82 cases (85.4%), a recurrent tumor developed earlier than a year after primary tumor therapy; forty-six were in group I and 69 in group II, age ranging from 18 years to 86 years (average: 57.6 years). The first group showed a statistically significant less amount of blood loss and a decreased incidence of infectious complications (P < 0.05). Additionally, there was a significant difference in functional outcomes (quality of life scores) but no significant difference in survival curves.

CONCLUSION

In properly elected patients, TLR is not just reasonable but tends to be a favorable alternative for recurrent oropharyngeal cancers compared to the outcomes of the open surgery group.

Keywords: Oropharyngeal cancer; Transoral laser resection; Open surgery; Recurrent tumor; Oropharyngeal squamous cell carcinoma

Core Tip: Our study included a large retrospective part and compared two prospective groups of patients, who were subjected to open surgery or transoral robotic surgery and laser resection (TLR). The results show that in properly elected patients, TLR is not just reasonable but has a tendency to be a favorable alternative for recurrent oropharyngeal cancer compared to the outcomes of the open surgery group. The use of TLR in our study was associated with shorter operating times, lower blood loss counts, lower postoperative complication rates, a higher quality of life and a proportionate 2-year survival when compared with open surgery performance rates. As open surgery was thought for decades to be the mainstream treatment approach for recurrent tumors of the oropharyngeal zone, considerable experience has accumulated which indicates that this management bears unfavorable functional outcomes. The results of our comparative study defined a higher quality of life in patients who underwent TLR.