Transoral robotic surgery base of tongue mucosectomy for head and neck cancer of unknown primary

2016 ◽  
Vol 87 (12) ◽  
pp. E281-E284 ◽  
Author(s):  
Suren Krishnan ◽  
James Connell ◽  
Enyinnaya Ofo
2018 ◽  
Vol 132 (10) ◽  
pp. 901-905 ◽  
Author(s):  
A Noor ◽  
L Stepan ◽  
S S-T Kao ◽  
N Dharmawardana ◽  
E H Ooi ◽  
...  

AbstractBackgroundThe role of panendoscopy in the modern investigation of head and neck cancer is changing with the development of improved radiological techniques, in-office biopsy capabilities and the low rate of synchronous primary tumours. This study aimed to review the indications for panendoscopy in the investigation of newly diagnosed head and neck cancer.MethodA retrospective review was conducted of 186 patients with newly diagnosed head and neck cancer, between January 2014 and December 2015, at two tertiary centres.ResultsObtaining a tissue diagnosis was the most common indication for panendoscopy (65 per cent), followed by surgical planning including transoral robotic surgery suitability assessment (22.6 per cent), and the investigation of carcinoma of an unknown primary (11.3 per cent). Two synchronous primary tumours were identified, generating a yield of 1.1 per cent.ConclusionPanendoscopy remains integral in the assessment of transoral robotic surgery suitability. Refining indications for modern panendoscopy could reduce the need for this procedure in this cohort of patients.


Author(s):  
Lars Axelsson ◽  
Erik Holmberg ◽  
Jan Nyman ◽  
Anders Högmo ◽  
Helena Sjödin ◽  
...  

Abstract Introduction Head and neck cancer of unknown primary (HNCUP) is a rare condition whose prognostic factors that are significant for survival vary between studies. No randomized treatment study has been performed thus far, and the optimal treatment is not established. Objective The present study aimed to explore various prognostic factors and compare the two main treatments for HNCUP: neck dissection and (chemo) radiation vs primary (chemo) radiation. Methods A national multicenter study was performed with data from the Swedish Head and Neck Cancer Register (SweHNCR) and from the patients' medical records from 2008 to 2012. Results Two-hundred and sixty HNCUP patients were included. The tumors were HPV-positive in 80%. The overall 5-year survival rate of patients treated with curative intent was 71%. Age (p < 0.001), performance status (p= 0.036), and N stage (p= 0.046) were significant factors for overall survival according to the multivariable analysis. Treatment with neck dissection and (chemo) radiation (122 patients) gave an overall 5-year survival of 73%, and treatment with primary (chemo) radiation (87 patients) gave an overall 5-year survival of 71%, with no significant difference in overall or disease-free survival between the 2 groups. Conclusions Age, performance status, and N stage were significant prognostic factors. Treatment with neck dissection and (chemo) radiation and primary (chemo) radiation gave similar survival outcomes. A randomized treatment study that includes quality of life is needed to establish the optimal treatment.


Head & Neck ◽  
2021 ◽  
Author(s):  
Mikkel H. H. Larsen ◽  
Susanne I. Scott ◽  
Hani I. Channir ◽  
Anne K. Ø. Madsen ◽  
Birgitte W. Charabi ◽  
...  

2014 ◽  
Vol 151 (1_suppl) ◽  
pp. P164-P164
Author(s):  
Lane D. Squires ◽  
Toby O. Steele ◽  
Vincent L. Biron ◽  
Quang K. Luu ◽  
D. Gregory Farwell ◽  
...  

2020 ◽  
Vol 9 (5) ◽  
pp. 1712-1720
Author(s):  
Shengjin Dou ◽  
Rongrong Li ◽  
Lin Zhang ◽  
Zhuoying Wang ◽  
Li Xie ◽  
...  

2019 ◽  
Vol 40 (5) ◽  
pp. 414-423 ◽  
Author(s):  
Megan Albertson ◽  
Srinivasa Chandra ◽  
Zafar Sayed ◽  
Craig Johnson

2008 ◽  
Vol 70 (4) ◽  
pp. 1100-1107 ◽  
Author(s):  
Michelle L. Klem ◽  
James G. Mechalakos ◽  
Suzanne L. Wolden ◽  
Michael J. Zelefsky ◽  
Bhuvanesh Singh ◽  
...  

2020 ◽  
Vol 102 (6) ◽  
pp. 442-450
Author(s):  
R Mistry ◽  
A Walker ◽  
D Kim ◽  
E Ofo

Introduction Head and neck carcinoma of unknown primary represents 1–5% of all head and neck cancers and presents a diagnostic and therapeutic dilemma. In approximately 40% of cases, a primary tumour location remains unknown despite investigation. With advancements in our understanding of the role of high-risk human papilloma virus in head and neck cancer, transoral robotic surgery presents an option for diagnosis and therapy. Materials and methods This is a retrospective case series from a single centre. Case notes were reviewed for 28 patients who had transoral robotic surgery for head and neck carcinoma of unknown primary between May 2015 and July 2019. Results Transoral robotic surgery identified an oropharyngeal primary tumour in 19 of 28 (67.8%) patients. All oropharyngeal primaries were p16 positive. The base of tongue identification rate was 63.2%. Median length of inpatient stay postoperatively was 1.0 day. Normal oral intake resumed within 48 hours in 96% (27/28) of patients. Three patients (10.3%) suffered minor postoperative bleeds that were all managed conservatively. Discussion The base of tongue primary identification rate (63.2%) in this series is consistent with that previously reported (43–63%; 95% confidence interval). Primary tumour identification rate if a patient is p16 positive is 86.3% (19/22), with 100% of these being oropharyngeal. We suggest future investigation into p16 status as a means of stratifying patients with head and neck carcinoma of unknown primary for transoral robotic surgery. Conclusion Transoral robotic base of tongue mucosectomy (or lingual tonsillectomy) is a promising technique that offers a high yield of positive identification for the primary tumour. It is well tolerated with minimal associated morbidity. Our findings are comparable with those in the current literature.


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