TORS – Oral Cancer News

Risk factors for positive surgical margins in salivary gland cancers

Source: www.physiciansweekly.com Author: Craig Bollig, MD An analysis of patients with salivary gland cancers shows that risk factors for positive surgical margins include age, tumor stage, and treatment center. “Salivary gland cancers are rare malignancies in the oropharynx that are primarily treated with surgery because they are relatively resistant to other therapies, such as radiation, chemotherapy, and immunotherapy,” Craig Bollig, MD, explains. “Surgical margins have been associated with cancer recurrence rates and survival in previous studies. However, because these tumors are so rare, there was not much information on risk factors for positive margins in this population prior to this study. Additionally, one of my primary clinical interests is transoral robotic surgery (TORS), which involves using a surgical robot to remove tumors located deep in the throat in a minimally invasive fashion through a patient’s mouth.” According to Dr. Bollig, previous research on the use of TORS in this population was limited, as were data on whether it was associated with similar positive margin rates compared with traditional surgical approaches. For a study published in American Journal of Otolaryngology—Head and Neck Medicine and Surgery, Dr. Bollig and colleagues obtained data from the National Cancer Database on patients with oropharyngeal salivary gland malignancies (OPSGM) from clinical T stages 1 to 4a who underwent surgical resection between 2010 and 2017. The researchers analyzed risk factors for positive surgical margins (PSM) using logistic regression and overall survival (OS) using Kaplan-Meier and Cox proportional hazards models. “Our objectives were to determine the clinical factors [...]

Oral Cancer Foundation News Team - A2022-09-06T09:55:57-07:00September, 2022|Oral Cancer News|

Transoral robotic surgery cuts patient recovery time

Source: exclusive.multibriefs.com Author: Carolina Pickens Oral cancer is diagnosed in almost 50,000 Americans each year and has a 57 percent survivability rate past five years, according to research from the Oral Cancer Foundation. 3D illustration of surgical robot The number of diagnoses has been fairly constant in oral and pharyngeal cancer for decades, but survivability has actually gone up slightly in the last 10 years. This can be attributed to the increasing percentage of patients with dental insurance attending annual appointments (when oral cancer is most often recognized and diagnosed earlier), the spread of HPV-related oral cancer (which is easier to treat) and advances in diagnostic tools for dentists and oral specialists. These advancements aren't limited to recognizing oral and throat cancer; strides in scientific approaches for surgical treatment are changing the way specialists treat oral phalangeal cancers. For example, Nepean Hospital of New South Wales has seen drastic improvement in patients' quality of life and surgical recovery time by performing transoral robotic surgery (TORS) with the da Vinci System. This technology provides surgeons the tools needed to perform successful, minimally-invasive surgeries for patients with T1 or T2 throat cancers. "Without the robot, tongue and throat cancers are among the most difficult tumors to surgically remove," said Dr. Chin, an otolaryngology, head and neck surgeon at the hospital. Previous surgical methods required surgeons cut into the neck to access tumors in the throat and back of the mouth — and operations would often last for up to 12 [...]

Oral Cancer Foundation News Team - A2017-07-30T14:52:05-07:00July, 2017|Oral Cancer News|

Incisionless robotic surgery offers promising outcomes for oropharyngeal cancer patients

Source: medicalxpress.com Author: press release, Henry Ford Health System A new study from researchers at Henry Ford Hospital finds an incisionless robotic surgery – done alone or in conjunction with chemotherapy or radiation – may offer oropharyngeal cancer patients good outcomes and survival, without significant pain and disfigurement. Patients with cancers of the base of tongue, tonsils, soft palate and pharynx who underwent TransOral Robotic Surgery, or TORS, as the first line of treatment experienced an average three-year survival from time of diagnosis. Most notably, the study's preliminary results reveal oropharyngeal cancer patients who are p16 negative – a marker for the human papilloma virus, or 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," says study lead author Tamer Ghanem, M.D., Ph.D., director of Head and Neck Oncology and Reconstructive Surgery Division in the Department of Otolaryngology-Head & Neck Surgery at Henry Ford Hospital. "Within our study, patients treated with robotic surgery had excellent results and survival, irrespective of their p16 status." Study results will be presented Sunday, Sept. 18 at the 2016 American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) annual meeting in San Diego. Led by Dr. Ghanem, Henry Ford Hospital in Detroit was among the first in the country to perform TORS using the da [...]

Oral Cancer Foundation News Team - A2016-09-18T06:20:43-07:00September, 2016|Oral Cancer News|

Scar-free surgery for cancer patients

Source: www.todayonline.com Author: staff Singapore — When Mdm Tan Chwee Huay told her friends that she had undergone surgery to remove a cancerous lump in her throat, they thought that she was pulling their leg. “Nobody could tell that I had gone for such a complex surgery because they could not see any scars. “They only learnt about my cancer diagnosis after the surgery, and they were shocked,” said the 75-year-old housewife, who was diagnosed with advanced-stage throat cancer in late 2010. Shortly after her diagnosis, Mdm Tan underwent a surgical procedure known as transoral robotic surgery (TORS) to remove a 2cm lump from the base of her tongue. Traditionally, conventional surgery for head and neck cancer involving the base of the tongue and throat required making large incisions in the neck, or sawing through the jaw to remove the growth, said Adjunct Assistant Professor Tay Hin Ngan, director of HN Tay ENT, Head and Neck, Thyroid, Sleep and Robotic Surgery at Mount Elizabeth Novena Hospital. Incisions from a typical open-neck surgery can extend beyond 20cm, said ENT/head and neck surgeon Dr Jeeve Kanagalingam, a visiting consultant at Johns Hopkins Singapore. While a skilled surgeon can conceal the incisions within creases or folds of the skin, Dr Kanagalingam said, patients who are predisposed to keloids could risk developing thick, raised scars. However, advancements in robot-assisted surgical systems have made it possible for surgeons to perform such surgeries without making a visible incision in the neck or face. Prof Tay, who [...]

Oral Cancer Foundation News Team - A2014-07-19T07:20:28-07:00July, 2014|Oral Cancer News|

Western University profs to test robotic treatment of throat cancer

Source: metronews.ca Author: Josh Elliott Western University professors David Palma and Anthony Nichols will lead a first-ever study to see if robotic surgery can treat throat cancer while avoiding the long-term side effects that come with chemotherapy and radiation. Transoral robotic surgery (TORS) allows doctors to use miniature robotic arms to operate in tight spaces where human hands can’t fit. London has the only TORS program in Canada. Early stage oropharyngeal cancer patients will be randomly assigned standard radiation care, or the new TORS treatment. Doctors will measure long-term side effects and quality of life following both treatments. Oropharyngeal cancer affects the back of the throat. Radiation therapy is effective at controlling the cancer, but some patients still suffer long-term side effects such as dry throat, difficulty swallowing, and hearing loss. “In the U.S., TORS is being used readily in the treatment of oropharyngeal cancer, in spite of the lack of high-level evidence supporting the use,” said Nichols, a head and neck cancer surgeon at London Health Sciences Centre. Palma, a radiation oncologist at LHSC, says the Western study will compare TORS treatment to traditional radiation therapy. “Before we can implement TORS, we need to prove that it meets that standard: Are the cure rates just as good, and are the side effects less?” Nichols sees reason for optimism: “Early studies of TORS show it holds promise to provide good disease control, as well as offer good speech and swallowing outcomes for patients.”

Oral Cancer Foundation News Team - A2012-07-18T06:09:13-07:00July, 2012|Oral Cancer News|

Quality-of-Life Outcomes in Transoral Robotic Surgery

Source: SAGE Journals Online Abstract Objective. To report long-term, health-related quality-of-life (HRQOL) outcomes in patients treated with transoral robotic surgery (TORS). Study Design. Prospective, longitudinal, clinical study on functional and HRQOL outcomes in TORS. Setting. University tertiary care facility. Subjects and Methods. Patients who underwent TORS were asked to complete a Head and Neck Cancer Inventory before treatment and at 3 weeks and 3, 6, and 12 months postoperatively. Demographic, clinicopathological, and follow-up data were collected. Results. Sixty-four patients who underwent TORS were enrolled. A total of 113 TORS procedures were performed. The mean follow-up time was 16.3 ± 7.49 months. The HRQOL was assessed at 3 weeks and at 3, 6, and 12 months, with a response rate of 78%, 44%, 41%, and 28%, respectively. TORS was performed most frequently for squamous cell carcinoma (88%). There was a decrease from baseline in the speech, eating, aesthetic, social, and overall QOL domains immediately after treatment. At the 1-year follow-up, the HRQOL scores in the aesthetic, social, and overall QOL domains were in the high domain. Patients with malignant lesions had significantly lower postoperative HRQOL scores in the speech, eating, social, and overall QOL domains (P < .05). Patients who underwent adjuvant radiation therapy or chemotherapy and radiation therapy had lower postoperative scores in the eating, social, and overall QOL domains (P < .05). Conclusion. The preliminary data show that patients who undergo TORS for malignancies and receive adjuvant therapy tend to have lower HRQOL outcomes. TORS is a promising, minimally [...]

Oral Cancer Foundation News Team - A2011-12-27T10:58:43-07:00December, 2011|Oral Cancer News|

Trans-oral robotic surgery has all the right stuff to remove head & neck cancers

Source: inventorspot.com Author: T Goodman Historically, surgical removal or oral and throat cancers have not allowed patients to go back to living their normal daily lives. Oral cancer removals caused severe pain, particularly ugly scarring, and an inability to eat, speak, or swallow normally. Even breathing problems might result. But now along comes TORS, the robot with the right stuff. Just over a dozen hospitals in the U.S. currently have the TORS, which stands for Trans-Oral Robotic Surgery. The system uses the da Vinci Surgical System, which has developed since the mid 90's to arguably be the most successful robotic surgery system in the world. It employs tiny robotic surgical instruments, operated from a command station by the appropriately trained human surgeon who maneuvers the robot's 'arms' and instruments. As with other da Vinci procedures, TORS has the benefits of being less invasive, with fewer complications and shorter hospital stays. There is less blood loss, little scarring, and fewer temporary and permanent side effects, such as loss of speech or swallowing ability. Generally, there is no need to begin cancer therapy with radiation, which would increase the discomfort and recovery time. Tamer A. Ghanem, M.D., Ph.D., director of Head and Neck Oncology and Reconstructive Surgery Division in the Department of OtolaryngologyHead & Neck Surgery at Henry Ford Hospital in Detroit, says that with TORS, "Surgeons operate with greater precision and control using the TORS approach, minimizing the pain, and reducing the risk of possible [...]

Oral Cancer Foundation News Team - A2011-09-02T19:22:47-07:00September, 2011|Oral Cancer News|

Mayo Clinic finds robotic surgery effective for removing hard-to-reach throat cancer

Source: www.eurekalert.org Author: press release Robotic surgery has become a mainstream tool for removing an ever-increasing variety of head and neck tumors. Now, a team of head and neck surgeons from Mayo Clinic has found robotic surgery can treat cancer in the narrow, hard-to-reach area beyond the tongue at the top of the voice box. Some patients were able to avoid further treatment with chemotherapy or radiation, and most could resume normal eating and speaking. "We've known it's useful for tongue base and tonsil cancers, but we wanted to assess its effectiveness in the larynx," says Kerry Olsen, M.D., Mayo Clinic otolaryngologist and senior author of the study that was presented April 29 at the Combined Otolaryngological Spring Meetings in Chicago. The investigation of transoral robotic surgery (TORS) followed nine patients for up to three years following removal of supraglottic squamous cell carcinoma, which affects the area of the larynx above the vocal cords. Most of the patients had advanced-stage disease. The results showed TORS effectively removed cancer, with "clean," disease-free margins, and was easier to perform than the approach of transoral laser microsurgery via a laryngoscope. The patients also underwent the surgical removal of their adjacent neck nodes at the same operation. "We were pleased with the cancer outcomes," Dr. Olsen says. "We also found patients had minimal trouble after surgery, in most cases resuming normal eating, swallowing and speaking." With TORS, the robotic arms that enter the mouth include a thin camera, an arm with a cautery or [...]

Oral Cancer Foundation News Team - A2011-04-30T16:14:07-07:00April, 2011|Oral Cancer News|

Robotic surgery for oral cancer

Source: speech-language-pathology-audiology.advanceweb.com Author: Advance, Vol 20, Issue 2 A minimally invasive surgical approach to treat benign tumors and select malignant tumors in adults has been cleared by the U.S. Food and Drug Administration (FDA). The da Vinci Surgical System, developed by head and neck surgeons at the University of Pennsylvania School of Medicine, in Philadelphia, has been cleared for transoral otolaryngologic surgical procedures. Gregory Weinstein, MD, FACS, and Bert O'Malley, Jr., MD, founded the first TransOral Robotic Surgery (TORS) program in the world at Penn Medicine in 2004. They developed and researched the TORS approach for a variety of robotic surgical neck approaches for both malignant and benign tumors of the mouth, larynx, tonsil, tongue, and other parts of the throat. Since 2005, approximately 350 patients at Penn have participated in the first prospective clinical trials of TORS. The trials compromise the largest and most comprehensive studies of the technology on record. "TORS has dramatically improved the way we treat head and neck cancer patients, completely removing tumors while preserving speech, swallowing, and other key quality-of-life issues," said Dr. O'Malley, chair of the Department of Otorhinolaryngology-Head and Neck Surgery at Penn Medicine. "It is very exciting that a concept conceived and tested at PENN and taught to surgeons and institutions within the U.S. and internationally has been officially recognized by our federal governing agencies and peers around the world as a new and improved therapy for select neck cancers and all benign tumors." As many as 45,000 Americans and approximately [...]

Oral Cancer Foundation News Team - A2010-05-09T10:23:23-07:00May, 2010|Oral Cancer News|

Transoral robotic surgery showed good oncologic, functional outcomes

Source: Author: Christen Haigh Patients with head and neck cancers treated with transoral robotic surgery — or TORS — had good disease control, disease free survival (DFS) and overall survival (OS), according to the findings of a preliminary study presented at the Multidisciplinary Head and Neck Cancer Symposium in Chandler, Ariz. “Disease control and survival rates using TORS appeared to be equivalent or near equivalent to those rates reported with chemoradiation, but with TORS, we need better functional outcome,” Eric Genden, MD, chief of the division of head and neck oncology at Mount Sinai Medical Center, New York, said during the presentation of the results. To determine the role of TORS in the treatment of oropharyngeal cancer, researchers prospectively evaluated patterns of failure, survival and functional outcomes of 25 patients treated with TORS and compared them with that of 12 patients treated with combined chemoradiation. The one-year locoregional control was 95%; distant control was 96%; DFS was 86% and OS was 86%. There was one local failure, one distant failure, one second primary failure and one comorbid death. Patients who received TORS had less acute toxicity two weeks after treatment vs. patients who received chemoradiotherapy. The TORS group had better eating ability than the chemoradiotherapy group (74% vs. 52%) and had improved diet vs. the chemoradiotherapy group (43% vs. 20%). Thus, TORS was associated with a higher overall functional oral intake scale score vs. that of the chemoradiotherapy group (5.3 vs. 3.2). Both groups had a score of 100% for [...]

Oral Cancer Foundation News Team - A2010-03-05T07:43:24-07:00March, 2010|Oral Cancer News|