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Scientific Oral Presentations

Head and Neck Surgery

Session: Scientific Oral Presentations 4 - Head and Neck Surgery

Recurrent Oropharyngeal Carcinoma Following Transoral Robotic Surgery Alone

Sunday, September 29, 2024
1:00 PM – 1:06 PM EDT
Location: MBCC, 208
Disclosure(s):
Kathryn L. Nunes, BA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Praneet C. Kaki, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Elliott M. Sina, BA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Dev R. Amin, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Adam J. Luginbuhl, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

David M. Cognetti, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Joseph M. Curry, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Transoral robotic surgery (TORS) is increasingly utilized as a standalone treatment for early-stage oropharyngeal cancer; however, factors associated with recurrence are still under investigation. The aim of this study is to understand the features associated with recurrence in those treated with TORS alone.

Methods: This is a retrospective review of patients who underwent TORS without neoadjuvant or adjuvant treatment between 2010 and 2023 at a single tertiary-care institution. Patients with primary tumors treated with TORS alone, grouped by those that were recommended observation after resection and those that declined adjuvant treatment, were included in this analysis. Patient characteristics, including demographic, clinical, surgical, oncologic and postoperative complications, were compared among patients that recurred to those that did not. Univariate logistic regression analysis was performed.

Results: Among 135 patients who received TORS as standalone treatment, 84 were recommended observation and 51 declined adjuvant. Recurrence rates were over twice as high in those that declined adjuvant (13.7% [local, 4 regional, and 1 distant] vs 6% [2 local; 3 regional], p = 0.013). On univariate analysis of the observation cohort, recurrence was associated with lower BMI (21.3 vs 27.6, p = 0.03). There was no significant difference in p16 status, pTNM, lymphovascular, or perineural invasion, extracapsular extension, or closest margin distance. Patients that recurred after declining adjuvant were significantly older age, increased Charleston Comorbidity Index (6, 2), perineural invasion (PNI), and 30-day complication rates (p < 0.05).

Conclusions: Higher BMI was positively associated with progression free survival in those who qualify for TORS alone. There were no significant differences in clinical, surgical or oncologic outcomes with recurrence. Younger age, lower CCI, no PNI, and lack of 30-day complications are positively associated with progression free survival in those that chose not to pursue adjuvant treatment.

    Presenting Author(s)

  • Kathryn L. Nunes, BA

    Medical Student
    Thomas Jefferson University Department of Otolaryngology
    Plymouth Meeting, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Praneet C. Kaki, BS

    Medical Student
    Sidney Kimmel Medical College, Thomas Jefferson University
    Kendall Park, New Jersey, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • PL

    Pablo Llerena, BS

    Thomas Jefferson University
    Ozone Park, New York, United States

    Disclosure information not submitted.

  • Elliott M. Sina, BA

    Medical Student
    Sidney Kimmel Medical College, Thomas Jefferson University
    Philadelphia, Pennsylvania, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Dev R. Amin, MD

    Resident Physician
    Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University
    Philadelphia, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • RG

    Richard A. Goldman, MD

    Associate Professor
    Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University Hospital
    Philadelphia, PA, United States

    Disclosure information not submitted.

  • Adam J. Luginbuhl, MD

    Professor
    Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University Hospital
    Philadelphia, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Presenting Author(s)

  • David M. Cognetti, MD

    Professor and Chair
    Thomas Jefferson Univ Hosp
    Penn Valley, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Senior Author(s)

  • Joseph M. Curry, MD

    Professor
    Thomas Jefferson University
    Wynnewood, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.