An incisionless robotic surgery may help easily remove certain head and neck tumours without visible scarring and improve survival in cancer patients, a new study has claimed.
Patients with cancer in the oropharynx – middle part of the throat that includes the tongue base, tonsils, soft palate and pharynx – who underwent TransOral Robotic Surgery (TORS) as the first line of treatment experienced an average three-year survival from time of diagnosis, researchers said.
The study, at Henry Ford Hospital in the US, found that the incisionless robotic surgery, done alone or in conjunction with chemotherapy or radiation, may offer oropharyngeal patients good outcomes.
The study shows oropharyngeal patients who are p16 negative – a marker for the human papilloma virus (HPV) that affects how well cancer will respond to treatment – have good outcomes with TORS in combination with radiation and/or chemotherapy.
“For non-surgical patients, several studies have shown that p16 positive throat cancers, or HPV- related throat cancers, have better survival and less recurrence than p16 negative throat cancers,” said lead author Tamer Ghanem, from the Henry Ford Hospital.
“Within our study, patients treated with robotic surgery had excellent results and survival, irrespective of their p16 status,” he added.
TORS offers patients an option to remove certain head and neck cancer tumours without visible scarring, while preserving speech and the ability to eat.
With the system, surgeons can access tumours through the mouth using the slender operating arms, thus not requiring an open skin incision.
Unlike traditional surgical approaches to head and neck cancer which require a large incision and long recovery, TORS patients are able to return to their normal lives only a few days after surgery without significant pain and disfigurement.
For the study, researchers wanted to take a closer look at the effectiveness of TORS for oropharyngeal cancer patients. They reviewed overall three-year survival, cancer control and metastasis, as well as the effect of p16 status on these variables.
The study included 53 oropharyngeal cancer patients who had TORS. Thirty-seven per cent underwent TORS alone, while more than 11 per cent had TORS with radiation therapy, and more than half received chemotherapy and radiation therapy.
Thirty-seven per cent underwent TORS alone, 11.4 per cent received radiation therapy, and 50 per cent received chemotherapy and radiation therapy. Eighty-one per cent of patients had p16 disease.
The study showed patients with a p16 negative marker had high survival (100 per cent) and low cancer recurrence when TORS was the first line of treatment, as well as when TORS was followed by chemotherapy or radiation therapy.
The majority of patients (63 per cent) were able to receive a lower dose of radiation after TORS, which reduces the risk of radiation side effects.