Transoral robotic surgery of tonsillar squamous cell carcinoma: analysis of 157 cases from five medical centers
10.3760/cma.j.cn115330-20240806-00463
- VernacularTitle:经口机器人手术治疗扁桃体鳞癌的临床应用价值：中国五家中心病例分析
- Author:
Lei TAO
1
;
Faya LIANG
;
Xiang LU
;
Ankui YANG
;
Liang ZHOU
;
Quan ZHANG
;
Xing ZHANG
;
Chunping WU
;
Huijun YANG
;
Longjuan CHU
;
Chao HE
;
Chengzhi XU
;
Jingtao CHEN
;
Ping HAN
;
Yan WANG
;
Xiaoming HUANG
;
Ming SONG
Author Information
1. 复旦大学附属眼耳鼻喉科医院耳鼻咽喉头颈外科，上海 200031
- Publication Type:Journal Article
- Keywords:
Tonsillar neoplasms;
Squamous cell carcinoma;
Transoral robotic surgery;
Overall survival;
Progression-free survival
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2025;60(3):258-265
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical application value of transoral robotic surgery (TORS) in the treatment of tonsil squamous cell carcinoma (TSCC).Methods:A retrospective analysis was conducted. The clinical data of 157 TSCC patients were collected who received TORS at five medical centers, namely, the Sun Yat-sen University Cancer Center, Sun Yat-sen Memorial Hospital, Eye Ear Nose and Throat Hospital of Fudan University, the First Affiliated Hospital of China Medical University, and Tongji Hospital of Tongji Medical College, from January 1 2017 to July 31 2022. There were 130 males and 27 females, aged 24-85 years. All patients were followed-up at least for 2 years (2-year group), among them, 99 patients had a follow-up of 3 years (3-year group). The overall survival (OS), progression-free survival (PFS), clinical stage, human papillomavirus (HPV) infection status were analyzed. SPSS 25.0 and SAS 9.4 were used for statistical analysis.Results:The OS and PFS of the 2-year group were 91.7% and 87.9%, respectively. The OS and PFS of the 3-year group were 85.9% and 82.8%, respectively. The prognosis of patients with locally early-stage was better than that of locally advanced patients, with the OS of 94.4% for T1-2 vs. 78.0% for T3 ( P=0.005) and the PFS of 91.2% for T1-2 vs. 75.0% for T3 ( P=0.011) in the 2-year group; the OS of 91.1% for T1-2 vs. 65.0% for T3 ( P=0.004) and the PFS of 88.6% for T1-2 vs. 60.0% for T3 ( P=0.002) in the 3-year group; and also, the OS of 90.0% for stage Ⅰ-Ⅱ vs. 79.5% for stage Ⅲ-Ⅳ ( P=0.204) and the PFS of 86.7% for stage Ⅰ-Ⅱ vs. 76.9% for stage Ⅲ-Ⅳ ( P=0.188) in the 3-year group. The prognosis of HPV-positive TSCC patients was better than that of HPV-negative patients in the 3-year group, with the OS of 90.9% for HPV-positive vs. 80.5% for HPV-negative ( P=0.045) and the PFS of 90.9% for HPV-positive vs. 75.6% for HPV-negative ( P=0.047). The average time of postoperative tracheal cannula indwelling was 25.1 days. The indwelling rate and average indwelling time of the postoperative nasogastric tube were 94.3% (148/157) and 8.5 days, respectively. Conclusion:TORS has outstanding survival benefits for TSCC patients. HPV-positive TSCC patients have a better prognosis than HPV-negative patients. TORS treatment of TSCC patients has advantages in postoperative recovery and quality of life.
