Days alive and out of hospital after treatment for oropharyngeal squamous cell carcinoma with primary transoral robotic surgery or radiotherapy – a prospective cohort study

Abstract

Background

With the rising incidence of oropharyngeal squamous cell cancer, there is a need to assess the burden of treatment.

Aims/objectives

This study assessed ‘days alive and out of hospital’ (DAOH) in a cohort of patients with oropharyngeal squamous cell carcinoma (OPSCC) treated with either transoral robotic surgery (TORS) or radiotherapy (RT).

Material and methods

A prospective cohort study conducted between May 2017–June 2019. Primary outcome was DAOH in the first 30 days after treatment (DAOH₃₀). The secondary outcome was DAOH₁₈₀.

Results

Forty-four patients were included, 31 treated with TORS and 13 with RT. Patients treated with TORS had a median DAOH₃₀ of 25 (IQR 22.8–26) including a required four-day postoperative stay- and a median DAOH₁₈₀ of 168 (IQR 163–171.3). In contrast, patients treated with RT had a median DAOH₃₀ of 30 (IQR 26–30) and a DAOH₁₈₀ of 143 days (IQR 135.5–149).

Conclusions and Significance

DAOH has not been examined in oropharyngeal cancer before. We found, patients overall spent 92.5% of the first 180 days alive and out of hospital. Patients treated with TORS had high DAOH₃₀, which remained high in DAOH₁₈₀, while patients treated with RT with reduced DAOH₃₀, had reduced DAOH₁₈₀ calling for further large-scale studies.

Chinese abstract

背景：随着口咽鳞状细胞癌的发病率上升, 有必要评估治疗负担。

目的：本研究评估了经口机器人手术（TORS）或放射疗法（RT）治疗的一组口咽鳞状细胞癌（OPSCC）患者的“存活和出院天数（DAOH）”。

材料和方法：2017年5月至2019年6月期间进行了前瞻性队列研究。主要结果是治疗后的前30天内的DAOH（DAOH₃₀）。次要结果是DAOH₁₈₀。

结果：共纳入44例患者, 其中31例接受TORS治疗, 13例接受RT治疗。接受TORS治疗的患者的DAOH₃₀中位数为25（IQR 22.8–26）, 其中包括术后需要住院的四天时间； DAOH₁₈₀的中位数为168（IQR 163–171.3）。相比之下, 接受RT治疗的患者的DAOH₃₀中位数为30（IQR 26-30）, DAOH₁₈₀中位数为143天（IQR 135.5-149）。

结论和意义：以前尚未检查过口咽癌DAOH。我们发现, 患者花时存活和出院天数的前180天的92.5％。接受TORS治疗的患者的DAOH₃₀较高, DAOH₁₈₀也较高, 而接受RT的患者的DAOH₃₀减少, DAOH₁₈₀也减少。这说明还需要进一步的大规模研究。

Keywords:

• Days Alive and Out of Hospital
• DAOH
• oropharyngeal cancer
• squamous cell carcinoma
• TORS
• radiotherapy

Disclosure statement

The authors have no conflicts of interest to declare.

Data availability statement

Source data available upon request to corresponding author

Trial registration and ethical approval

The study was conducted in accordance with the Declaration of Helsinki and was approved by the local ethical committee (H-1-2014-033 and H-17015164). Written informed consent was obtained. The study protocol has been published on clinicaltrials.gov (NCT03418909).

Additional information

Funding

SIS received a PhD grant from a private non-profit foundation.