Transoral robotic surgery alone for oropharyngeal cancer: Quality-of-life outcomes

Garret W. Choby, Jeehong Kim, Diane C. Ling, Shira Abberbock, Rajarsi Mandal, Seungwon Kim, Robert L. Ferris, Umamaheswar Duvvuri

Research output: Contribution to journalArticle

Abstract

IMPORTANCE: Few studies have examined quality-of-life (QOL) outcomes in patients who undergo transoral robotic surgery (TORS) alone (ie, without adjuvant radiotherapy or chemoradiotherapy). OBJECTIVE: To report QOL outcomes of patients with oropharyngeal squamous cell carcinoma who receive only TORS. DESIGN, SETTING, AND PARTICIPANTS: Medical records for all patients undergoing TORS for treatment of primary oropharyngeal squamous cell carcinoma from May 1, 2010, to March 31, 2014, at a tertiary care academic cancer center were examined from June through September 2014. Thirty-four patients who did not receive adjuvant therapy after TORS were included in the study. INTERVENTION: Primary surgical resection via TORS. MAINOUTCOMES ANDMEASURES: The University of Washington Quality of Life, version 4, questionnaire was completed by patients preoperatively and at 1-, 6-, 12-, and 24-month intervals after TORS. Demographic, clinicopathologic, and follow-up data were collected. RESULTS: Mean follow-up time was 14 months (May 1, 2010, to April 30, 2014). Most patients had T1 (20 [59%]) or T2 (13 [38%]) and N0 (13 [38%]) or N1 (16 [47%]) disease. Statistically significant improvement in QOL outcomes was noted in the following postoperative domains: chewing from1 month (median, 50 [IQR, 50-100]) to 12 months (100 [IQR,100-100]; P =.048), swallowing from 1 month (70 [IQR,30-85]) to6 months (100 [IQR, 70-100]; P =.047) and 1 to 24 months (100 [IQR, 70-100]; P =.048), pain from 1 month (38 [IQR, 25-75]) to 6 months (88 [IQR, 75-100]; P =.006) and 1 to 12 months after surgery (100 [IQR, 75-100]; P =.01), and activity from 1 month (63 [IQR, 50-88]) to 24 months (100 [IQR, 75-100]; P =.03). Two participants (6%) died during the follow-up period: 1 because of disease and 1 because of a myocardial infarction. Two patients (6%) required temporary gastrostomy tube placement, but none required tracheostomy. CONCLUSIONS AND RELEVANCE: Appropriately selected patients who undergo TORS alone for oropharyngeal squamous cell carcinoma experience acceptable short- and long-term QOL outcomes.

Original languageEnglish (US)
Pages (from-to)499-504
Number of pages6
JournalJAMA Otolaryngology - Head and Neck Surgery
Volume141
Issue number6
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

Fingerprint

Oropharyngeal Neoplasms
Robotics
Quality of Life
Squamous Cell Carcinoma
Adjuvant Chemoradiotherapy
Adjuvant Radiotherapy
Gastrostomy
Tracheostomy
Mastication
Tertiary Healthcare
Deglutition
Medical Records
Myocardial Infarction
Demography
Pain

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

Cite this

Transoral robotic surgery alone for oropharyngeal cancer : Quality-of-life outcomes. / Choby, Garret W.; Kim, Jeehong; Ling, Diane C.; Abberbock, Shira; Mandal, Rajarsi; Kim, Seungwon; Ferris, Robert L.; Duvvuri, Umamaheswar.

In: JAMA Otolaryngology - Head and Neck Surgery, Vol. 141, No. 6, 01.01.2015, p. 499-504.

Research output: Contribution to journalArticle

Choby, Garret W. ; Kim, Jeehong ; Ling, Diane C. ; Abberbock, Shira ; Mandal, Rajarsi ; Kim, Seungwon ; Ferris, Robert L. ; Duvvuri, Umamaheswar. / Transoral robotic surgery alone for oropharyngeal cancer : Quality-of-life outcomes. In: JAMA Otolaryngology - Head and Neck Surgery. 2015 ; Vol. 141, No. 6. pp. 499-504.
@article{f8aeb466e4cf4e4f87a5d1281ca1f403,
title = "Transoral robotic surgery alone for oropharyngeal cancer: Quality-of-life outcomes",
abstract = "IMPORTANCE: Few studies have examined quality-of-life (QOL) outcomes in patients who undergo transoral robotic surgery (TORS) alone (ie, without adjuvant radiotherapy or chemoradiotherapy). OBJECTIVE: To report QOL outcomes of patients with oropharyngeal squamous cell carcinoma who receive only TORS. DESIGN, SETTING, AND PARTICIPANTS: Medical records for all patients undergoing TORS for treatment of primary oropharyngeal squamous cell carcinoma from May 1, 2010, to March 31, 2014, at a tertiary care academic cancer center were examined from June through September 2014. Thirty-four patients who did not receive adjuvant therapy after TORS were included in the study. INTERVENTION: Primary surgical resection via TORS. MAINOUTCOMES ANDMEASURES: The University of Washington Quality of Life, version 4, questionnaire was completed by patients preoperatively and at 1-, 6-, 12-, and 24-month intervals after TORS. Demographic, clinicopathologic, and follow-up data were collected. RESULTS: Mean follow-up time was 14 months (May 1, 2010, to April 30, 2014). Most patients had T1 (20 [59{\%}]) or T2 (13 [38{\%}]) and N0 (13 [38{\%}]) or N1 (16 [47{\%}]) disease. Statistically significant improvement in QOL outcomes was noted in the following postoperative domains: chewing from1 month (median, 50 [IQR, 50-100]) to 12 months (100 [IQR,100-100]; P =.048), swallowing from 1 month (70 [IQR,30-85]) to6 months (100 [IQR, 70-100]; P =.047) and 1 to 24 months (100 [IQR, 70-100]; P =.048), pain from 1 month (38 [IQR, 25-75]) to 6 months (88 [IQR, 75-100]; P =.006) and 1 to 12 months after surgery (100 [IQR, 75-100]; P =.01), and activity from 1 month (63 [IQR, 50-88]) to 24 months (100 [IQR, 75-100]; P =.03). Two participants (6{\%}) died during the follow-up period: 1 because of disease and 1 because of a myocardial infarction. Two patients (6{\%}) required temporary gastrostomy tube placement, but none required tracheostomy. CONCLUSIONS AND RELEVANCE: Appropriately selected patients who undergo TORS alone for oropharyngeal squamous cell carcinoma experience acceptable short- and long-term QOL outcomes.",
author = "Choby, {Garret W.} and Jeehong Kim and Ling, {Diane C.} and Shira Abberbock and Rajarsi Mandal and Seungwon Kim and Ferris, {Robert L.} and Umamaheswar Duvvuri",
year = "2015",
month = "1",
day = "1",
doi = "10.1001/jamaoto.2015.0347",
language = "English (US)",
volume = "141",
pages = "499--504",
journal = "Archives of Otolaryngology",
issn = "2168-6181",
publisher = "American Medical Association",
number = "6",

}

TY - JOUR

T1 - Transoral robotic surgery alone for oropharyngeal cancer

T2 - Quality-of-life outcomes

AU - Choby, Garret W.

AU - Kim, Jeehong

AU - Ling, Diane C.

AU - Abberbock, Shira

AU - Mandal, Rajarsi

AU - Kim, Seungwon

AU - Ferris, Robert L.

AU - Duvvuri, Umamaheswar

PY - 2015/1/1

Y1 - 2015/1/1

N2 - IMPORTANCE: Few studies have examined quality-of-life (QOL) outcomes in patients who undergo transoral robotic surgery (TORS) alone (ie, without adjuvant radiotherapy or chemoradiotherapy). OBJECTIVE: To report QOL outcomes of patients with oropharyngeal squamous cell carcinoma who receive only TORS. DESIGN, SETTING, AND PARTICIPANTS: Medical records for all patients undergoing TORS for treatment of primary oropharyngeal squamous cell carcinoma from May 1, 2010, to March 31, 2014, at a tertiary care academic cancer center were examined from June through September 2014. Thirty-four patients who did not receive adjuvant therapy after TORS were included in the study. INTERVENTION: Primary surgical resection via TORS. MAINOUTCOMES ANDMEASURES: The University of Washington Quality of Life, version 4, questionnaire was completed by patients preoperatively and at 1-, 6-, 12-, and 24-month intervals after TORS. Demographic, clinicopathologic, and follow-up data were collected. RESULTS: Mean follow-up time was 14 months (May 1, 2010, to April 30, 2014). Most patients had T1 (20 [59%]) or T2 (13 [38%]) and N0 (13 [38%]) or N1 (16 [47%]) disease. Statistically significant improvement in QOL outcomes was noted in the following postoperative domains: chewing from1 month (median, 50 [IQR, 50-100]) to 12 months (100 [IQR,100-100]; P =.048), swallowing from 1 month (70 [IQR,30-85]) to6 months (100 [IQR, 70-100]; P =.047) and 1 to 24 months (100 [IQR, 70-100]; P =.048), pain from 1 month (38 [IQR, 25-75]) to 6 months (88 [IQR, 75-100]; P =.006) and 1 to 12 months after surgery (100 [IQR, 75-100]; P =.01), and activity from 1 month (63 [IQR, 50-88]) to 24 months (100 [IQR, 75-100]; P =.03). Two participants (6%) died during the follow-up period: 1 because of disease and 1 because of a myocardial infarction. Two patients (6%) required temporary gastrostomy tube placement, but none required tracheostomy. CONCLUSIONS AND RELEVANCE: Appropriately selected patients who undergo TORS alone for oropharyngeal squamous cell carcinoma experience acceptable short- and long-term QOL outcomes.

AB - IMPORTANCE: Few studies have examined quality-of-life (QOL) outcomes in patients who undergo transoral robotic surgery (TORS) alone (ie, without adjuvant radiotherapy or chemoradiotherapy). OBJECTIVE: To report QOL outcomes of patients with oropharyngeal squamous cell carcinoma who receive only TORS. DESIGN, SETTING, AND PARTICIPANTS: Medical records for all patients undergoing TORS for treatment of primary oropharyngeal squamous cell carcinoma from May 1, 2010, to March 31, 2014, at a tertiary care academic cancer center were examined from June through September 2014. Thirty-four patients who did not receive adjuvant therapy after TORS were included in the study. INTERVENTION: Primary surgical resection via TORS. MAINOUTCOMES ANDMEASURES: The University of Washington Quality of Life, version 4, questionnaire was completed by patients preoperatively and at 1-, 6-, 12-, and 24-month intervals after TORS. Demographic, clinicopathologic, and follow-up data were collected. RESULTS: Mean follow-up time was 14 months (May 1, 2010, to April 30, 2014). Most patients had T1 (20 [59%]) or T2 (13 [38%]) and N0 (13 [38%]) or N1 (16 [47%]) disease. Statistically significant improvement in QOL outcomes was noted in the following postoperative domains: chewing from1 month (median, 50 [IQR, 50-100]) to 12 months (100 [IQR,100-100]; P =.048), swallowing from 1 month (70 [IQR,30-85]) to6 months (100 [IQR, 70-100]; P =.047) and 1 to 24 months (100 [IQR, 70-100]; P =.048), pain from 1 month (38 [IQR, 25-75]) to 6 months (88 [IQR, 75-100]; P =.006) and 1 to 12 months after surgery (100 [IQR, 75-100]; P =.01), and activity from 1 month (63 [IQR, 50-88]) to 24 months (100 [IQR, 75-100]; P =.03). Two participants (6%) died during the follow-up period: 1 because of disease and 1 because of a myocardial infarction. Two patients (6%) required temporary gastrostomy tube placement, but none required tracheostomy. CONCLUSIONS AND RELEVANCE: Appropriately selected patients who undergo TORS alone for oropharyngeal squamous cell carcinoma experience acceptable short- and long-term QOL outcomes.

UR - http://www.scopus.com/inward/record.url?scp=84934325108&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84934325108&partnerID=8YFLogxK

U2 - 10.1001/jamaoto.2015.0347

DO - 10.1001/jamaoto.2015.0347

M3 - Article

C2 - 25834991

AN - SCOPUS:84934325108

VL - 141

SP - 499

EP - 504

JO - Archives of Otolaryngology

JF - Archives of Otolaryngology

SN - 2168-6181

IS - 6

ER -