Neck dissection and trans oral robotic surgery for oropharyngeal squamous cell carcinoma

Objective: Trans Oral Robotic Surgery (TORS) is a modality in the management of oropharyngeal squamous cell carcinoma(OPSCC). This study was planned to determine whether Selective Neck Dissection (SND) is oncological safe procedure even in patients with lymph node metastases. Methods: OPSCC patients were divided into Modified Radical Neck Dissection (MRND) and SND groups. The outcome measures were overall survival (OS), disease-free survival (DFS) and regional recurrence free survival (RRFS). Results: Thirty-seven SNDs and 18 MRNDs were performed. Regional relapse rate was 6.1% in SND group whilst 18.8% in MRND group(p = 0.19). The 5-year OS, DFS and RRFS rates' differences were not statistically significant between SND and MRND groups (p = 0.40, p = 0.42 and p = 0.18, respectively). At multivariate analysis, advanced stage impacted the 5-year OS and DFS(HR = 9.39, p < 0.01 and HR = 11.03, p = 0.04). Conclusions: The SND seems to be effective in a TORS framework. The indication should be accurately discussed by the multidisciplinary tumor board. (C) 2021 Japanese Society of Otorhinolaryngology-Head and Neck Surgery, Inc. Published by Elsevier B.V. All rights reserved.

Automated summary

This study aimed to determine whether Selective Neck Dissection (SND) is a safe procedure for patients with lymph node metastases. The results showed no significant differences in overall survival, disease-free survival, and regional recurrence free survival between SND and Modified Radical Neck Dissection (MRND) groups. Advanced stage was found to impact the 5-year overall survival and disease-free survival. Therefore, the indication for SND should be carefully discussed in a TORS framework.