Narrowband Imaging for p16+ Unknown Primary Squamous Cell Carcinoma Prior to Transoral Robotic Surgery

2020 ◽  
Vol 163 (6) ◽  
pp. 1198-1201
Author(s):  
Kareem Al-Mulki ◽  
James Hamilton ◽  
Azeem S. Kaka ◽  
Brian J. Boyce ◽  
H. Michael Baddour ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Robotic Surgery ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Transoral Robotic Surgery ◽  
Unknown Primary ◽  
Inclusion Criteria ◽  
Level Of Evidence ◽  
Carcinoma Of Unknown Primary ◽  
Narrowband Imaging

Our purpose was to assess the potential utility of narrowband imaging (NBI) as a tool in diagnosing and treating unknown primary oropharyngeal squamous cell carcinoma (OPSCC) in patients prior to diagnostic resection with transoral robotic surgery (TORS). Between 2016 and March 2019, 29 patients with carcinoma of unknown primary meeting inclusion criteria were identified and treated with TORS. NBI was used preoperatively in 9 of 29 patients. A suspected tumor site was delineated by NBI in 8 of 9 patients (89%). Of the patients imaged with NBI, 8 of 9 (89%) patients had a pathologically confirmed tumor following TORS, corresponding to the same 8 suspected tumor sites identified with NBI. In contrast, a primary tumor was localized following TORS in 15 of 20 (75%) patients not evaluated with NBI. Thus, we see NBI as a potentially useful tool for the diagnosis and management of p16+ carcinoma of unknown primary. Level of Evidence: IIb

Transoral robotic surgery for the management of head and neck squamous cell carcinoma of unknown primary

2015 ◽  
Vol 135 (10) ◽  
pp. 1051-1057 ◽  
Author(s):  
Hani Ibrahim Channir ◽  
Niclas Rubek ◽  
Hans Ulrik Nielsen ◽  
Katalin Kiss ◽  
Birgitte W Charabi ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Robotic Surgery ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Transoral Robotic Surgery ◽  
Neck Squamous Cell Carcinoma ◽  
Unknown Primary ◽  
Carcinoma Of Unknown Primary

scholarly journals Finding/identifying primaries with neck disease (FIND) clinical trial protocol: a study integrating transoral robotic surgery, histopathological localisation and tailored deintensification of radiotherapy for unknown primary and small oropharyngeal head and neck squamous cell carcinoma

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e035431 ◽  
Author(s):  
John R de Almeida ◽  
Christopher W Noel ◽  
Maria Veigas ◽  
Rosemary Martino ◽  
Douglas B Chepeha ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Robotic Surgery ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Combined Treatment ◽  
Transoral Robotic Surgery ◽  
Primary Site ◽  
Unknown Primary ◽  
Patient Reported

IntroductionCarcinomas of unknown primary site (CUP) of the head and neck have historically been worked up and managed heterogeneously. Failure to identify a primary site may result in large radiotherapy mucosal volumes. Transoral approaches such as Transoral Robotic Surgery (TORS) may improve the yield of identifying hidden primaries. We aim to assess the oncological and functional outcomes of a combined treatment approach with TORS and tailored radiotherapy.Methods and analysisTwenty-five patients with metastatic squamous cell carcinoma to the neck without clinical or radiographic evidence of a primary site will be enrolled in a phase II trial. Patients will undergo a diagnostic or therapeutic approach with TORS based on specific algorithms incorporating tailored radiotherapy according to the location and laterality of the primary tumour. The primary outcome is to evaluate the out-of-field failure rate over a 2-year period. Secondary outcomes include identification rates, survival outcomes, patient reported outcomes and functional swallowing outcomes.Ethics and disseminationThe University Health Network Research Ethics Board approved this study (ID 15–9767). The results will be published in an open access journal.Trial registration numberNCT03281499.

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