Robotic Surgery Effective for Head and Neck Cancer

A new study has found that less-invasive robotic surgery for upper airway and digestive track malignant tumors is as successful as other minimally invasive surgical techniques, based on patient function and survival.

Researchers at the University of Alabama (Birmingham, USA) and the Mayo Clinic (Rochester, MN, USA) conducted a prospective case study involving 89 patients with head and neck squamous cell carcinoma; 71 had T1 (29 patients) or T2 (42 patients) tumors, while 18 patients had T3 (8 patients) or T4 (10 patients) tumors. There were 24 patients with overall stage I or II disease and 65 with stage III or IV disease. The patients underwent transoral robotic-assisted resection between March 2007 and December 2008, with a median follow-up time of 26 months. The main outcome measures were disease-free survival, cancer recurrence, and gastrostomy tube dependence.

The results showed that at the time of the last follow-up visit, there had been a total of 11 patients with recurrent cancer, 3 with local recurrence and 7 with regional (two of whom also had distant metastases); one patient had recurrent distant cancer; in all, 7 patients were treated for recurrent disease. Eighty-two patients had no evidence of disease, one patient died of the disease, two died of other disease, and four were alive with disease at the last follow-up visit. Results of Kaplan-Meier survival analysis showed that the 2-year recurrence-free survival rate for the cohort was 86.5%. None of the patients were gastrostomy-tube dependent at the last follow-up visit.

According to the authors, the study results are encouraging and show robotic surgery offers a technically feasible and oncologically sound alternative treatment for some patients with head and neck squamous cell carcinomas, but caution that more work needs to be done. The study was published in the December 20, 2010, issue of the Archives of Otolaryngology - Head & Neck Surgery.

"All of the patients in the study had regained full swallowing ability at the time of the last follow up visit and none remained feeding-tube dependent,” said senior author UAB otolaryngologist J. Scott Magnuson, MD. "The early functional and oncologic results justify the continued treatment of select patients with head and neck squamous cell carcinomas with robotic-assisted surgeries.”

Related Links:
University of Alabama
Mayo Clinic