Evaluating the Efficacy of Transoral Robotic Surgery (TORS) Versus Radiotherapy, Chemotherapy, and Open Surgery in Treating Oropharyngeal Squamous Cell Carcinoma (OPSCC): A Systematic Review of Reviews
DOI:
https://doi.org/10.52609/jmlph.v5i2.154Keywords:
Chemotherapy, Radiotherapy, Robotic Surgical Procedures, Squamous Cell Carcinoma of Head and NeckAbstract
Introduction:
Transoral robotic surgery (TORS) is a minimally invasive surgical approach for oropharyngeal squamous cell carcinoma (OPSCC) that aims to reduce morbidity and improve patients' quality of life without compromising oncological outcomes. In this study, we investigate the use of TORS in the management of OPSCC and compare it with intensity-modulated radiation therapy (IMRT), concurrent chemoradiation therapy (CCRT), and open surgery.
Method:
We conducted a systematic review of systematic reviews using PubMed, Cochrane databases, and grey literature. We also searched the reference lists of these articles. The keywords used were "trans-oral robotic surgery" OR "TORS" AND "oropharynx" OR "oropharyngeal cancer". The inclusion criteria were systematic reviews of human studies that focused on patients diagnosed with OPSCC. We excluded non-English articles without translations and articles that did not meet the inclusion criteria.
Result:
Our review included a total of 10 studies, comprising 16,917 patients. TORS was found to have better oncological outcomes than other modalities, and was associated with similar overall survival and disease-free survival rates as IMRT and CCRT. Additionally, TORS was associated with less postoperative bleeding than open surgery.
Conclusion:
Our findings suggest that TORS is a safe and effective treatment option for OPSCC. It may be a good option for patients seeking a minimally invasive approach with less postoperative bleeding.
References
Rao KN, Gangiti KK. Transoral robotic surgery. Indian J Surg Oncol. 2021;12(4):847-53. Epub 20210909. doi: 10.1007/s13193-021-01443-0. PubMed PMID: 35110913; PubMed Central PMCID: PMC8764010.
Pongsapich W, Chongkolwatana C, Chuetnok H, Ratanaprasert N. The implementation of TORS for head and neck surgery in Thailand. J Robot Surg. 2021;15(6):955-61. Epub 20210202. doi: 10.1007/s11701-021-01202-x. PubMed PMID: 33532951.
Yeh DH, Tam S, Fung K, MacNeil SD, Yoo J, Winquist E, et al. Transoral robotic surgery vs. radiotherapy for management of oropharyngeal squamous cell carcinoma - A systematic review of the literature. Eur J Surg Oncol. 2015;41(12):1603-14. Epub 20150926. doi: 10.1016/j.ejso.2015.09.007. PubMed PMID: 26461255.
Liu HH, Li LJ, Shi B, Xu CW, Luo E. Robotic surgical systems in maxillofacial surgery: a review. Int J Oral Sci. 2017;9(2):63-73. doi: 10.1038/ijos.2017.24. PubMed PMID: 28660906; PubMed Central PMCID: PMC5518975.
Chan JY, Richmon JD. Transoral robotic surgery (TORS) for benign pharyngeal lesions. Otolaryngol Clin North Am. 2014;47(3):407-13. doi: 10.1016/j.otc.2014.02.003. PubMed PMID: 24882798.
Cammaroto G, Stringa LM, Zhang H, Capaccio P, Galletti F, Galletti B, et al. Alternative applications of trans-oral robotic surgery (TORS): A systematic review. J Clin Med. 2020;9(1). Epub 20200111. doi: 10.3390/jcm9010201. PubMed PMID: 31940794; PubMed Central PMCID: PMC7019293.
Lang S, Mattheis S, Kansy B. TORS in HPV-positive tumors-the new standard? Recent Results Cancer Res. 2017;206:207-18. doi: 10.1007/978-3-319-43580-0_16. PubMed PMID: 27699541.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. doi: 10.1136/bmj.n71.
De Virgilio A, Costantino A, Mercante G, Pellini R, Ferreli F, Malvezzi L, et al. Transoral robotic surgery and intensity-modulated radiotherapy in the treatment of the oropharyngeal carcinoma: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol. 2021;278(5):1321-35. Epub 20200721. doi: 10.1007/s00405-020-06224-z. PubMed PMID: 32696250.
de Almeida JR, Byrd JK, Wu R, Stucken CL, Duvvuri U, Goldstein DP, et al. A systematic review of transoral robotic surgery and radiotherapy for early oropharynx cancer: a systematic review. Laryngoscope. 2014;124(9):2096-102. Epub 20140527. doi: 10.1002/lary.24712. PubMed PMID: 24729006.
Egbunah UP, Adekunle AA, Adeyemo WL. Comparing the effectiveness of non-surgical and surgical treatment modalities in the management of oral cancer: A systematic review and meta-analysis. FACE. 2021;2(2):110-20. doi: 10.1177/27325016211022010.
Park DA, Lee MJ, Kim SH, Lee SH. Comparative safety and effectiveness of transoral robotic surgery versus open surgery for oropharyngeal cancer: A systematic review and meta-analysis. Eur J Surg Oncol. 2020;46(4 Pt A):644-9. Epub 20190925. doi: 10.1016/j.ejso.2019.09.185. PubMed PMID: 31627931.
Roselló À, Albuquerque R, Roselló-Llabrés X, Marí-Roig A, Estrugo-Devesa A, López-López J. Transoral robotic surgery vs open surgery in head and neck cancer. A systematic review of the literature. Med Oral Patol Oral Cir Bucal. 2020;25(5):e599-e607. Epub 20200901. doi: 10.4317/medoral.23632. PubMed PMID: 32683380; PubMed Central PMCID: PMC7473442.
Sharbel DD, Abkemeier M, Sullivan J, Zimmerman Z, Albergotti WG, Duvvuri U, Byrd JK. Transcervical arterial ligation for prevention of postoperative hemorrhage in transoral oropharyngectomy: Systematic review and meta-analysis. Head Neck. 2021;43(1):334-44. Epub 20200925. doi: 10.1002/hed.26480. PubMed PMID: 32974970.
Kelly K, Johnson-Obaseki S, Lumingu J, Corsten M. Oncologic, functional and surgical outcomes of primary transoral robotic surgery for early squamous cell cancer of the oropharynx: a systematic review. Oral Oncol. 2014;50(8):696-703. Epub 20140607. doi: 10.1016/j.oraloncology.2014.04.005. PubMed PMID: 24917389.
Stokes W, Ramadan J, Lawson G, Ferris FRL, Holsinger FC, Turner MT. Bleeding complications after transoral robotic surgery: A meta-analysis and systematic review. Laryngoscope. 2021;131(1):95-105. Epub 20200228. doi: 10.1002/lary.28580. PubMed PMID: 32108347.
Ramchandani JP, Brunet A, Skalidi N, Faulkner J, Rovira A, Simo R, et al. Neck dissection timing in transoral robotic or laser microsurgery in oropharyngeal cancer: A systematic review. OTO Open. 2022;6(4):2473974x221131513. Epub 20221011. doi: 10.1177/2473974x221131513. PubMed PMID: 36247656; PubMed Central PMCID: PMC9558876.
Park YM, Byeon HK, Chung HP, Choi EC, Kim SH. Comparison study of transoral robotic surgery and radical open surgery for hypopharyngeal cancer. Acta Otolaryngol. 2013;133(6):641-8. Epub 20130228. doi: 10.3109/00016489.2012.761350. PubMed PMID: 23448352.
White H, Ford S, Bush B, Holsinger FC, Moore E, Ghanem T, et al. Salvage surgery for recurrent cancers of the oropharynx: comparing TORS with standard open surgical approaches. JAMA Otolaryngol Head Neck Surg. 2013;139(8):773-8. doi: 10.1001/jamaoto.2013.3866. PubMed PMID: 23949352.
Iorio GC, Arcadipane F, Martini S, Ricardi U, Franco P. Decreasing treatment burden in HPV-related OPSCC: A systematic review of clinical trials. Crit Rev Oncol Hematol. 2021;160:103243. Epub 20210129. doi: 10.1016/j.critrevonc.2021.103243. PubMed PMID: 33516806.
Blanco RG, Fakhry C, Ha PK, Ryniak K, Messing B, Califano JA, Saunders JR. Transoral robotic surgery experience in 44 cases. J Laparoendosc Adv Surg Tech A. 2013;23(11):900-7. Epub 20131001. doi: 10.1089/lap.2013.0261. PubMed PMID: 24083851.
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Copyright (c) 2024 Abdulrhman Alsayeg, Maha Naif Alshammari, Abdulrahman Mesfer Alajmi, Reem Faihan Alotaibi
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