TransOral Robotic Surgery – 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|

Year in review: Head and neck cancer

Source: www.medpagetoday.com Author: Ian Ingram, Deputy Managing Editor, MedPage In 2019, headlines in head and neck cancer were dominated by a new first-line approval in squamous cell carcinoma (SCC), further attempts at treatment deintensification in the lower-risk human papillomavirus (HPV) population, and a provocative trial looking at patients' quality of life following either robotic surgery or radiation. Immunotherapy OK'd in First-line Based on data from the three-arm KEYNOTE-048 trial, the FDA approved pembrolizumab (Keytruda) for the first-line treatment of metastatic or unresectable recurrent head and neck SCC. The PD-1 immune checkpoint inhibitor was approved in combination with chemotherapy for all patients, or as monotherapy for those with PD-L1 expression. Final results of the study demonstrated a 23% reduction in the hazard for death for the group treated with pembrolizumab plus platinum chemotherapy (cisplatin or carboplatin) and 5-fluorouracil. This group had a median overall survival of 13.0 months, as compared with 10.7 months for those treated with the EXTREME regimen of platinum chemotherapy plus 5-fluorouracil and cetuximab (Erbitux). A pembrolizumab monotherapy arm of KEYNOTE-048 showed non-inferiority to EXTREME in all comers and superiority in patients with a PD-L1 combined positive score (CPS) ≥1, as represented by a 22% reduction in the hazard for death over the study period. In this CPS ≥1 population, which made up about 85% of the study population, median overall survival was 12.3 with pembrolizumab alone versus 10.3 months with EXTREME. ORATOR Trial Upends Assumption of Surgical Superiority In the first randomized trial to pit transoral robotic [...]

Oral Cancer Foundation News Team - A2019-11-16T13:32:00-07:00November, 2019|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|

Stanford surgeon uses robot to increase precision, reduce complications of head and neck procedures

Source: scopeblog.stanford.edu Author: Margarita Gallardo In today’s San Francisco Chronicle, writer Kristen Brown highlights how surgical robots are simplifying head and neck procedures. Known as transoral robotic surgery, or TORS, Stanford is one of the few places in the country using the da Vinci surgical robot to remove tumors or scar tissue from patients such as 70-year-old John Ayers, who is featured in the story (subscription required). Edward Damrose, MD, chief of the division of laryngeal surgery at Stanford Hospital & Clinics, describes the procedure to Brown: The da Vinci’s most frequent use in transoral procedures is in head and neck cancers. By operating through the mouth, surgeons can remove tumors in places that previously might have required much more complex procedures, such as breaking the jaw to get a good enough look. The robot has four arms – three that can hold typical surgical tools, and a fourth that holds an endoscopic camera, giving a surgeon a full view of the patient’s insides. “You get an almost panoramic view,” said Damrose. “It’s as if you were miniaturized and in someone’s throat looking around.” The da Vinci was first used on a human for a head and neck procedure in 2005 at the University of Pennsylvania. An update to the robot made the experiment possible, when slimmer tools were developed for the robot that might more easily fit inside the mouth. (Even with the smaller tools, working inside someone’s throat can be a tight squeeze, depending on the patient.) “If [...]

Oral Cancer Foundation News Team - A2013-07-04T06:05:53-07:00July, 2013|Oral Cancer News|

Robotic surgery vs. radiation, chemo for throat cancer, study to see which is best

By: Sheryl Ubelacker, The Canadian Press, April 17, 2013Source: ottawacitizen.com TORONTO - It was quite a shock for Rod Sinn when he learned the persistent sore throat he'd had for five months, initially diagnosed as tonsillitis, was actually an increasingly common form of throat cancer caused by the human papilloma virus. Equally unpleasant was the news that the standard treatment for oropharyngeal cancer, which typically affects the back of the tongue, tonsils and nearby tissues, is radiation and chemotherapy. Sinn, a physically fit non-smoker who only drinks alcohol occasionally, had seen what the double-barrelled treatment could do. A friend diagnosed with throat cancer a year earlier and given the standard treatment lost his salivary glands and sense of taste. "I thought, wait a minute, there's got to be another option. I really don't like the side-effects of all that radiation," the 52-year-old businessman, who lives in Oakville, Ont., near Toronto, said Tuesday. After searching the Internet, he discovered doctors at Western University in London, Ont., were the only ones in Canada performing robotic-assisted surgery for throat cancer. Sinn had the robotic surgery in spring 2011, plus a follow-up operation to remove some lymph nodes for testing to make sure his cancer hadn't spread. While the surgery left him unable to swallow for several weeks and he lost some taste buds for a time, he is virtually back to normal except for some numbness in his neck where the lymph nodes were removed. "It was fantastic," said Sinn, who counts himself a believer [...]

Charlotte Parker2013-04-18T16:40:32-07:00April, 2013|Oral Cancer News|

Team approach improves oral cancer outcomes

Source: www.drbicuspid.com Author: Donna Domino, Features Editor Providence Cancer Center in Portland, OR, is one of a growing number of facilities that is working to improve care for patients with oral cancer and head and neck cancers through a multidisciplinary program that brings together a spectrum of treatment providers. To illustrate the challenges many oral cancer patients face, R. Bryan Bell, MD, DDS, medical director of the Oral, Head and Neck Cancer Program at Providence, described the extreme effects the illness and its treatment had on one of his patients. The woman had undergone surgery, chemotherapy, and radiation for her oral cavity cancer. "This was a beautiful 32-year-old woman who had lost all her teeth and couldn't chew," Dr. Bell told DrBicuspid.com. "She had aged about 40 years during treatment, and she just looked awful. But she had no means of affording needed dental rehabilitation, which would have cost about $60,000. People need to see what happens when you don't restore these patients." Dr. Bell used the woman's case to convince officials at Providence Health, which oversees the medical center, of the need for a multidisciplinary approach for these patients. The new cancer treatment center, which opened last month, is a unique collaboration between dental and medical oncology specialists. The center provides coordinated care for oral cancer patients who often need expensive and complex dental rehabilitation, regardless of their ability to pay, according to Dr. Bell. His team includes head and neck surgical oncologists, radiation oncologists, medical oncologists, otolaryngologists, neuro-otologists, [...]

Oral Cancer Foundation News Team - A2013-01-28T14:52:16-07:00January, 2013|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|

Robots vs. radiation

Source: the-scientist.com Author: Bob Grant Scientists at London, Ontario-based Lawson Health Research Institute have launched the first ever study of the comparative effectiveness of robotic-assisted surgery versus radiation therapy for the treatment of oropharyngeal cancer, or cancer of the back of the throat. Transoral robotic surgery (TORS), a new method for removing tumors from the throat developed in 2004, approved by the US Food and Drug Administration in 2010, and already used in many hospitals in the United States, may be a good way for throat cancer patients to avoid some of radiation therapy’s side effects, which include speech problems, hearing loss, skin discoloration, taste changes, difficulty swallowing, and dry mouth. “Early studies of TORS show it holds promise to provide good disease control, as well as offer good speech and swallowing outcomes for patients,” said London Health Sciences Center (LHSC) head and neck surgeon Anthony Nichols in a statement cialis otc canadianviagras.com. “However, it is important that we conduct a thorough comparison of the two treatments.” Researchers conducting the so-called ORATOR trial will track quality of life, side effects, and survival in cancer patients randomly assigned to receive either TORS or radiation therapy. “Radiation has worked very well for the treatment of these cancers and has set a very high standard for treatment,” said LHSC radiation oncologist David Palma in a statement. “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 [...]

Oral Cancer Foundation News Team - A2012-07-13T17:51:43-07:00July, 2012|Oral Cancer News|