Robotics surgery may improve outcomes in mouth and throat cancer

Source: eandt.theiet.org Author: E&T editorial staff Robotic surgery may improve the health outcomes in mouth and throat cancer patients, including better long-term survival, new research suggests. The method used for the study focused on oropharyngeal cancer that occurs in the back of the throat and includes the base of the tongue and tonsils. In transoral robotic surgery, a surgeon uses a computer-enhanced system to guide an endoscope – a flexible tube with a light and camera attached to it – to provide high-resolution, 3D images of the back of the mouth and throat. Naturally, this is an area that is difficult to reach with conventional tools; therefore, robots can be used during this procedure. Here, two robotically guided instruments, acting as a surgeon’s arms, work around corners to safely remove tumours from surrounding tissue. The observational study, conducted by non-profit Los Angeles hospital Cedars-Sinai, used data from the US National Cancer Database and included 9,745 surgical patients – 2,694 of whom underwent transoral robotic surgery between 2010 and 2015. “At a minimum, robotic surgery for oropharyngeal cancer patients seems safe and effective compared to what’s been the standard of care for many years,” said Zachary S Zumsteg, assistant professor of Radiation Oncology at Cedars-Sinai, referring to standard surgery, radiation therapy, and chemotherapy. The researchers found that the five-year overall survival rate for patients with early-stage disease who underwent robotic surgery was 84.5 per cent, compared with 80.3 per cent for patients who had non-robotic surgery. They adjusted for differences in [...]

Robotic surgery yields better quality of life for OC patients

Source: www.drbicuspid.com Author: Donna Domino, Features Editor Patients with oropharyngeal squamous cell carcinoma maintain a high quality of life a year after having transoral robotic surgery, according to a new study in the JAMA Otolaryngology -- Head & Neck Surgery (April 10, 2013). But elderly patients and those treated with adjuvant treatments such as external-beam radiation therapy and chemoradiation therapy do not, according to the study authors. Patients with oropharyngeal squamous cell carcinoma (OPSCC) have historically been treated with primary open surgery. However, cure rates were low, complication rates were high, and patient health-related quality of life (HRQOL) decreased, the researchers noted. Efforts to minimize morbidity and preserve organs have shifted treatments to primary external-beam radiation therapy or chemoradiation therapy, but these treatments are often associated with significant side effects and decreased quality of life, they added. Transoral laser microsurgery was pioneered in the 1990s by Wolfgang Steiner, MD, for laryngeal tumors and eventually adapted to the oropharynx. Since then, primary laser microsurgery has yielded favorable treatment outcomes for OPSCC patients, the researchers noted. Transoral robotic surgery (TORS), a more minimally invasive approach, was introduced in 2005 and has since been recognized as "oncologically sound," while also preserving function in OPSCC patients. Complication rates are low and swallowing function remains high, according to the study authors. Research has shown that speech, eating, social, and overall quality of life tend to decrease but remain high three months after TORS. However, long-term results among a significant number of patients are lacking. Long-term quality [...]

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 [...]

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 [...]

University of Rochester expands robotic surgeries to oral, pharyngeal cancers

Source: www.healthcanal.com Author: staff Doctors at University of Rochester Medical Center are first in upstate New York to incorporate the precision and dexterity of a surgical robot to remove cancerous tumors in the mouth and throat. The first transoral robotic procedure – a partial glossectomy -- was performed Feb. 8 by surgeon Matthew Miller, M.D. This procedure expands the Medical Center’s robot-assisted surgery capabilities to include procedures for head and neck, urologic and gynecologic conditions. “Traditional approaches to these tumors have the potential to be invasive and disfiguring – oftentimes leading to an extensive recovery and rehabilitation period,” said Miller, a fellowship trained head and neck cancer surgeon. “The robot allows us to limit or even eliminate some of the side effects associated with more invasive surgeries while still effectively treating the cancer.” Strong Memorial Hospital’s daVinci Surgical Systems consist of robotic arms that replicate a surgeon’s motions in real time. The movements are by a surgeon using high-definition images provided by cameras positioned within the patient’s mouth. The surgeon is working from a console, across the room from the patient. Traditional surgery for some head and neck cancers requires large incisions – extending from the lip, across the chin and to the neck before entering the mouth or throat. Many times surgeons need to cut through the lower jaw and move aside vital cranial nerves to gain access to the back of the mouth and throat. Using the high-precision robotic system, surgeons insert the slender instruments into the mouth [...]

2010-02-18T08:53:06-07:00February, 2010|Oral Cancer News|

Laser microsurgery for tongue cancer

Source: www.ajho.com Author: staff A retrospective chart review undertaken at a Rush University Medical Center in Chicago, Illinois, indicates that transoral laser surgery to treat cancer of the tongue is as effective as open surgery. The less invasive procedure may also improve patients' quality of life. The study reviewed data from 71 patients who underwent transoral laser microsurgery for squamous cell carcinoma of the base of the tongue. At 24 months, overall survival was 90% and disease-specific survival was 94%. Of the 46 patients for whom quality-of-life information was obtained, the majority reported mild or no pain, minimally impaired to normal swallowing, and normal speech. Surgical approaches through the neck once provided the only safe access to the base of the tongue, although the voice box, trachea, esophagus, lymph nodes, muscles, and large nerves make surgical resection in this area difficult. Significant complications often included impairment of speech and of swallowing. Transoral laser microsurgery, using an endoscope with a lighted camera, a microscopic lens, and a CO-2 laser, enables surgeons to treat cancers that were not treatable previously. Dr Guy Petruzzelli, study author and chief of the Section of Head, Neck and Skull Base Surgery at Rush University Medical Center, noted, “Due to the precision of this surgery, most patients require less adjuvant chemotherapy, and in some cases patients will not need chemotherapy. And the functional outcomes are superior. Patients are able to speak and swallow much sooner and better than with an open technique.” Of patients responding, 91% reported [...]

Robot-assisted surgery feasible for head and neck cancer

Source: www.medscape.com Author: Roxanne Nelson Robot-assisted surgery appears feasible for resection of select upper aerodigestive tract tumors, according to a study published in the April issue of Archives of Otolaryngology — Head & Neck Surgery. Researchers found that the surgical robot had several advantages over traditional endoscopic and open approaches, such as 3-dimensional visualization, tremor filtration, and greater freedom of instrument movement. "Robotic surgery in head and neck patients is still considered investigational," said senior author William Carroll, MD, associate professor of surgery and otolaryngology at the University of Alabama in Birmingham. "The procedure is under consideration by the [US Food and Drug Administration] for an approved indication." The key message from this study is that this technology could prove useful for the surgical management of select patients with head and neck cancers. "We hope to see similar or improved cure rates with fewer side effects and quicker return to function," he told Medscape Oncology. Since they were introduced a decade ago, robot-assisted surgeries have become widely accepted in the United States, especially for cardiac, gynecologic, and urologic procedures. The authors note that in 2007, about 60% of all radical prostatectomies were performed with robot assistance, and that robot-assisted cardiac and urological procedures can result in less blood loss and fewer complications than standard open approaches. In addition, the use of robots in cardiac surgery has had a favorable effect on operative time, length of stay in intensive care units, and length of overall inpatient care days, compared with open [...]

Doctors pleased with robotic technique

Source: www.postbulletin.com Author: staff People heal faster with robotic throat-cancer surgery and have no major complications, Mayo Clinic research shows. The part of the throat behind the mouth can be difficult to reach for surgeons, says a Mayo statement. Surgery for throat tumor removal typically requires a hospital stay of seven to 10 days. But researchers say using a "da Vinci robotic surgical system" instead of traditional surgery led to average hospital stays of 2.3 days for 45 patients studied. Robotic surgery is now Mayo's "technique of choice" after more than 100 such procedures, Moore said. "The results of this research were even more positive than we expected. We found great advantages to using transoral robotic surgery for tonsil and base-of-the-tongue cancers," said head and neck surgeon Dr. Eric Moore.

Go to Top