Abstract A23: Transoral robotic surgery for primary oncologic resection: Outcomes from a rural academic medical center

Objective: to report the outcomes of oncologic transoral robotic surgery (TORS) performed by a single surgeon.

Study Design: Retrospective chart review.

Methods: All patients who underwent a TORS primary oncologic resection between the years of 2010-2018 were reviewed. Data regarding demographics, comorbidities, prior treatment, tumor characteristics, surgery, complications, adjuvant therapy, and survival were obtained.

Results: Sixty-four patients were included in the chart review with a median age of 60.8 years. Fifty patients were male and 17 were female. Average overall robotic operating time was 137.9 minutes. Forty-one cases were presented using the Da Vinci Si while 23 cases were performed using the Da Vinci Xi. There was no significant difference between these two groups with regards to operative time, complication rate, or survival. Average robotic operative times for tonsil and tongue base primaries were 151.3 and 112.1 minutes, respectively. The difference was approaching statistical significance (p=0.053). Forty-two patients underwent ligation of external carotid artery (ECA) branches whereas 23 patients did not. One major oropharyngeal bleeding complication occurred in a patient who did not receive ECA branch ligation, which resulted in death. No major bleeding complication occurred in the ligation cohort. There was no significant difference in the overall rate of complications between low ACE 27 and high ACE 27 individuals (p = 0.22). However, the number of reported complications is significantly greater in the high ACE 27 group relative to the low ACE 27 group (0.74 vs. 1.82, p = 0.016). There was no significant difference in survival between HPV+ and HPV- tumors.

Conclusion: Transoral robotic surgery represents a safe and effective means for resection of malignancies of the oropharynx. Although statistical significance cannot be demonstrated, ECA branch ligation should be considered prior to TORS given the severity of potential complications.

Citation Format: Eric Eisen, Christiaan Rees, Isabelle Magro, Karissa LeClair, Joseph Paydarfar. Transoral robotic surgery for primary oncologic resection: Outcomes from a rural academic medical center [abstract]. In: Proceedings of the AACR-AHNS Head and Neck Cancer Conference: Optimizing Survival and Quality of Life through Basic, Clinical, and Translational Research; 2019 Apr 29-30; Austin, TX. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(12_Suppl_2):Abstract nr A23.