Transoral robotic surgery in the management of head and neck squamous cell cancer with unknown primary

Abstract

Background: Transoral robotic surgery (TORS) assisted base of the tongue (BOT) resection has been suggested as part of the work-up for head and neck squamous cell cancer with unknown primary (HNSCC-CUP). Success rates vary with regard to identification of primary BOT lesions, and cases with likely such lesions appear to be included in previous reports.

Objectives: To analyse the possible benefits of a superficial TORS-assisted BOT resection in thoroughly investigated HNSCC-CUP.

Material and methods: Retrospectively, 13 patients subjected to superficial TORS-assisted BOT resections due to HNSCC-CUP, where previous thorough work-ups including PET-scans had been performed and primary lesions had still not been identified, were reviewed.

Results: Nodal status, according to the TNM-8 classification, was N1, N2, N2a, N2b, N2c, and N3, respectively, for 7, 1, 1, 4, 0, and 0 patients. In 38% of the cases, T1 BOT cancers were identified using superficial TORS-assisted BOT resections and treatments adjusted.

Conclusion: Addition of a superficial TORS-assisted BOT resection to the work-up of HNSCC-CUP frequently identifies primary lesions and alters the treatment for this group of patients even after thorough work-up.

Chinese abstract

背景：经口机器人手术（TOR）辅助舌根切除术（BOT）被认为是原发性未知的头颈部鳞状细胞癌（HNSCC-CUP）治疗的一部分。在原发性BOT病变的鉴别方面, 有不同的成功率。这种病变的可能性病例在以前的报告中似乎已包括。

目的：分析浅表TOR辅助BOT切除对于透彻研究HNSCC-CUP的可能益处。

材料与方法：回顾性分析13例因HNSCC-CUP行浅表TOR辅助BOT切除术的患者。他们既往做过包括PET扫描在内的彻底检查, 但仍未发现原发性病变。

结果：按TNM7分类法, 6例、1例、5例、1例和0例患者的结节状况分别为N1、N2a、N2b、N2c和N3。在38%的病例中, T1-BOT癌是通过浅表TOR辅助BOT切除和调整治疗来确定的。

结论：在HNSCC-CUP手术中加用浅表TORS辅助BOT切除术, 即使在彻底手术后, 也能经常发现原发性病变, 并为这类病人改变治疗方法。

Keywords:

• CUP
• head and neck cancer
• squamous cell cancer
• treatment
• TORS

Disclosure statement

No potential conflict of interest was reported by the authors.