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Robotic lateral oropharyngectomy following diagnostic tonsillectomy is oncologically safe in patients with high risk human papillomavirus related squamous cell cancer

Lookup NU author(s): Dr Hans Sathasivam, James O'HaraORCiD, Dr David Meikle, Dr Charles Kelly, Dr Max RobinsonORCiD, Professor Vinidh Paleri

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Abstract

© 2018 Springer-Verlag GmbH Germany, part of Springer Nature Purpose: Diagnostic tonsillectomy is rarely an oncologic operation owing to close or positive margins. The standard of care is for further treatment to the primary site, typically with adjuvant radiotherapy. Methods: 14 patients with close or positive margins following a diagnostic tonsillectomy underwent transoral robotic surgery (TORS) and lateral oropharyngectomy; five patients with the longest follow-up had their excision specimens examined with a step serial sectioning technique (SSS). Results: Conventional histopathological examination of the TORS resection specimens did not demonstrate residual carcinoma in 13 patients, confirmed by examination using SSS in 5 patients. There were no post-operative complications or long-term functional deficit. Seven patients received surgery alone with 100% overall and disease specific survival, respectively (median follow-up 27.5 months; range 5.2–50.4). Conclusions: This prospective study suggests that TORS lateral oropharyngectomy alone is an oncologically safe treatment when close or positive margins are identified on diagnostic tonsillectomy in HPV-positive SCC.

Publication metadata

Author(s): Siddiq S, Cartlidge D, Stephen S, Sathasivam HP, Fox H, O'Hara J, Meikle D, Iqbal MS, Kelly CG, Robinson M, Paleri V

Publication type: Article

Publication status: Published

Journal: European Archives of Oto-Rhino-Laryngology

Year: 2018

Volume: 275

Issue: 7

Pages: 1853-1860

Print publication date: 01/07/2018

Online publication date: 12/05/2018

Acceptance date: 06/04/2018

ISSN (print): 0937-4477

ISSN (electronic): 1434-4726

Publisher: Springer Verlag

URL: https://doi.org/10.1007/s00405-018-4968-6

DOI: 10.1007/s00405-018-4968-6

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