Second primary squamous cell carcinomas treated with trans oral robotic surgery: Oncological and functional results

Abstract

Abstract Background Recovery of swallowing in patients treated with trans‐oral robotic surgery (TORS) is in general considered as favorable. However, patients afflicted with a secondary primary carcinoma of the head and neck may be more vulnerable to swallowing dysfunctions after trans‐oral surgery as a consequence of previous treatments. Methods This is a retrospective monocentric study on patients undergoing TORS for second primary squamous cell carcinoma between 2013 and 2017 (follow‐up until June 2021). Swallowing performance was assessed via the functional outcome swallowing scale (FOSS). Also, overall survival (OS), disease‐free survival (DS) and disease‐specific survival (DSS) were evaluated. Results Eighteen patients (median 62 years) underwent TORS with curative intent for T1‐2 oropharyngeal and supraglottic secondary primaries. The average follow‐up was of 52 months. All cases were resected R0 using TORS. 84% of patients had a post‐treatment FOSS score equal or better upon last follow‐up compared with pre‐treatment. Only one patient required a percutaneous gastrostomy long term. DSS/DFS/OS at 5 years was 94%, 60%, and 67%, respectively. The main cause of death was metachronous pulmonary neoplasia. Conclusions Our study demonstrates encouraging results in terms of swallowing recovery in patients undergoing TORS for selected secondary primaries of the oropharynx and supraglottic larynx. Further studies into trans‐oral surgery for this condition seem therefore warranted. Level of Evidence: Case series; Level 4.

Keywords

• second primary
• squamous cell carcinoma
• survival
• swallow function
• TORS
• transoral robotic surgery