TY - JOUR
T1 - Robotic surgery may improve overall survival for T1 and T2 tumors of the hypopharynx
T2 - An NCDB cohort study
AU - Finegersh, Andrey
AU - Voora, Rohith S.
AU - Panuganti, Bharat
AU - Faraji, Farhoud
AU - Christopher Holsinger, F.
AU - Brumund, Kevin T.
AU - Coffey, Charles
AU - Califano, Joseph
AU - Orosco, Ryan K.
N1 - Publisher Copyright:
© 2021
PY - 2021/10
Y1 - 2021/10
N2 - Background: Hypopharyngeal cancer is associated with poor survival. Robotic surgery is emerging as a treatment for hypopharyngeal tumors, but no rigorous data are available to assess its effect on survival. Methods: The National Cancer Database (NCDB) was used to identify patients with T1 and T2 hypopharyngeal tumors undergoing robotic surgery, laser surgery, and primary radiation with or without chemotherapy from 2010 to 2016. All adult patients with available staging and no distant metastasis were included. Results: We compared 57 patients undergoing robotic surgery, 236 undergoing laser surgery, and 5,742 undergoing primary radiation. Compared to laser surgery, patients undergoing robotic surgery were significantly more likely to have negative margins, neck dissection, lower incomes, and care at an academic center. Rates of robotic surgery also significantly increased from 2010 to 2015. After multivariate regression, robotic surgery was associated with significantly improved overall survival compared to laser surgery and primary radiation. Conclusion: Robotic surgery improves overall survival for T1 and T2 hypopharyngeal tumors compared to laser surgery and primary radiation in this NCDB cohort. This effect may be mediated by decreased positive margin rates relative to laser surgery. Rates of hypopharyngeal robotic surgery are expected to increase with wider adoption of robotic platforms and may improve overall survival rates for hypopharyngeal cancer.
AB - Background: Hypopharyngeal cancer is associated with poor survival. Robotic surgery is emerging as a treatment for hypopharyngeal tumors, but no rigorous data are available to assess its effect on survival. Methods: The National Cancer Database (NCDB) was used to identify patients with T1 and T2 hypopharyngeal tumors undergoing robotic surgery, laser surgery, and primary radiation with or without chemotherapy from 2010 to 2016. All adult patients with available staging and no distant metastasis were included. Results: We compared 57 patients undergoing robotic surgery, 236 undergoing laser surgery, and 5,742 undergoing primary radiation. Compared to laser surgery, patients undergoing robotic surgery were significantly more likely to have negative margins, neck dissection, lower incomes, and care at an academic center. Rates of robotic surgery also significantly increased from 2010 to 2015. After multivariate regression, robotic surgery was associated with significantly improved overall survival compared to laser surgery and primary radiation. Conclusion: Robotic surgery improves overall survival for T1 and T2 hypopharyngeal tumors compared to laser surgery and primary radiation in this NCDB cohort. This effect may be mediated by decreased positive margin rates relative to laser surgery. Rates of hypopharyngeal robotic surgery are expected to increase with wider adoption of robotic platforms and may improve overall survival rates for hypopharyngeal cancer.
KW - Head and neck cancer
KW - Hypopharynx
KW - Robotic surgery
KW - Transoral laser surgery
KW - Transoral robotic surgery
UR - http://www.scopus.com/inward/record.url?scp=85111207954&partnerID=8YFLogxK
U2 - 10.1016/j.oraloncology.2021.105440
DO - 10.1016/j.oraloncology.2021.105440
M3 - Article
C2 - 34329867
AN - SCOPUS:85111207954
SN - 1368-8375
VL - 121
JO - Oral Oncology
JF - Oral Oncology
M1 - 105440
ER -