1. Robotic lateral oropharyngectomy following diagnostic tonsillectomy is oncologically safe in patients with high risk human papillomavirus related squamous cell cancer.
- Author
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Siddiq, Somiah, Cartlidge, David, Stephen, Sarah, Sathasivam, Hans P., Fox, Hannah, O'hara, James, Meikle, David, Iqbal, Muhammad Shahid, Kelly, Charles G., Robinson, Max, and Paleri, Vinidh
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TONSILLECTOMY complications , *HUMAN papillomavirus vaccines , *SQUAMOUS cell carcinoma , *CANCER treatment , *SURGICAL robots , *CANCER risk factors - Abstract
Purpose: Diagnostic tonsillectomy is rarely an oncologic operation owing to close or positive margins. The standard of care is for further treatment to the primary site, typically with adjuvant radiotherapy.Methods: 14 patients with close or positive margins following a diagnostic tonsillectomy underwent transoral robotic surgery (TORS) and lateral oropharyngectomy; five patients with the longest follow-up had their excision specimens examined with a step serial sectioning technique (SSS).Results: Conventional histopathological examination of the TORS resection specimens did not demonstrate residual carcinoma in 13 patients, confirmed by examination using SSS in 5 patients. There were no post-operative complications or long-term functional deficit. Seven patients received surgery alone with 100% overall and disease specific survival, respectively (median follow-up 27.5 months; range 5.2-50.4).Conclusions: This prospective study suggests that TORS lateral oropharyngectomy alone is an oncologically safe treatment when close or positive margins are identified on diagnostic tonsillectomy in HPV-positive SCC. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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