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- Title
Specimen-Based Resection Margins and Local Control during Transoral Robotic Surgery for Oropharyngeal HPV-Mediated Squamous Cell Carcinoma.
- Authors
Magliocca, Kelly R.; Kaka, Azeem S.; Barrow, Emily M.; Studer, Matthew B.; Griffith, Christopher C.; Ernst, Jacqueline; Meade, Tara; Balicki, Andrew; Boyce, Brian J.; Schmitt, Nicole C.; Bur, Andres M.; Schmitt, Alessandra C.; Jackson, Ryan; Steuer, Conor E.; Beitler, Jonathan J.; Patel, Mihir R.
- Abstract
Objectives: The aim of the study was to investigate the association of surgical margin conditions, including positive specimen margins revised to negative relative to local recurrence, disease-free survival, and overall survival (OS) within a cohort of HPV-mediated oropharyngeal squamous cell carcinoma (OPSCC) who underwent en bloc resection via transoral robotic surgery (TORS). Materials and Methods: Retrospective cohort of patients with untreated HPV-mediated OPSCC cT1 or T2 undergoing TORS resection between October 2014 and March 2020. The methodologic description of our interdisciplinary institutional approach, number of cut-through margins (CTMs) during intraoperative consultation, percentage of final positive margin cases, and disease-free survival and OS stratified by margin status and margin tumor-free distance is identified. Results: 135 patients with primary cT1/T2 HPV-mediated OPSCC met inclusion criteria. Twenty-eight of 135 (20.7%) specimens revealed CTM and were revised during the same operative setting. Three of 135 (2.2%) surgical cases had positive final margin status. Local control rate was 97%. On univariate analysis, margin distance did not impact OS. CTM and final positive margins had lower OS than initially negative margins (p = 0.044). Pathologic N-stage significantly impacted OS (p < 0.001). Conclusions: High local control rate and low final positive margin status confound the study of specimen margin-based techniques in HPV-mediated OPSCC resected en bloc with TORS. Pathologic N-stage may impact OS more than margin status. Larger numbers are needed to confirm differences.
- Subjects
SURGICAL robots; SQUAMOUS cell carcinoma; SURGICAL margin; SURGERY; PROGRESSION-free survival; MOHS surgery
- Publication
ORL, 2023, Vol 85, Issue 2, p80
- ISSN
0301-1569
- Publication type
Article
- DOI
10.1159/000527369