Background: The squamous cell carcinoma (SCC) of the posterior pharyngeal wall (PPW) is associated with poor oncological outcomes based on current literature data. We reported the preliminary outcomes of a potential new treatment protocol based on neoadjuvant chemotherapy (NCT) and transoral robotic surgery (TORS). Methods: A retrospective single-center case series was performed including a total of 20 patients diagnosed with a SCC of the PPW between October 2010 and September 2021. All patients successfully completed TORS with neck dissection after NCT. Adjuvant treatment was performed in the presence of adverse pathologic features. Loco-regional control (LRC), overall survival (OS), and disease-specific survival (DSS) were defined as the time from surgery to tumor recurrence or death, as appropriate. Survival estimates were calculated by Kaplan-Meier analysis. Surgical data and post-operative functional outcomes were also reported. Results: Estimated 3-year LRC, OS, and DSS rates (95% Confidence interval) were 59.7% (39.7-89.6), 58.6% (38.7-88.8), and 69.4% (49.9-96.6). The median hospital stay was 21 days (IQR 17.0-23.5). Oral diet and decannulation were achieved after a median of 14 days (IQR 12.0-15.0). Feeding tube and tracheostomy dependence after 6 months was observed in 3 (15%) and 2 (10%) patients, respectively. Conclusions: The use of NCT followed by TORS for PPW SCC treatment appears to have good oncological and functional outcomes for both early and locally advanced cancers. Further randomized trials and site-specific guidelines are needed.

Neoadjuvant chemotherapy and transoral robotic surgery for the posterior pharyngeal wall carcinoma / Costantino, Andrea; Meliante, Piero Giuseppe; Sampieri, Claudio; Lee, Kyuin; Ralli, Massimo; De Vincentiis, Marco; De Virgilio, Armando; Kim, Se-Heon. - In: EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY AND HEAD & NECK. - ISSN 1434-4726. - 280:10(2023), pp. 4649-4655. [10.1007/s00405-023-08070-1]

Neoadjuvant chemotherapy and transoral robotic surgery for the posterior pharyngeal wall carcinoma

Meliante, Piero Giuseppe
Secondo
;
Ralli, Massimo;De Vincentiis, Marco;De Virgilio, Armando
Penultimo
;
2023

Abstract

Background: The squamous cell carcinoma (SCC) of the posterior pharyngeal wall (PPW) is associated with poor oncological outcomes based on current literature data. We reported the preliminary outcomes of a potential new treatment protocol based on neoadjuvant chemotherapy (NCT) and transoral robotic surgery (TORS). Methods: A retrospective single-center case series was performed including a total of 20 patients diagnosed with a SCC of the PPW between October 2010 and September 2021. All patients successfully completed TORS with neck dissection after NCT. Adjuvant treatment was performed in the presence of adverse pathologic features. Loco-regional control (LRC), overall survival (OS), and disease-specific survival (DSS) were defined as the time from surgery to tumor recurrence or death, as appropriate. Survival estimates were calculated by Kaplan-Meier analysis. Surgical data and post-operative functional outcomes were also reported. Results: Estimated 3-year LRC, OS, and DSS rates (95% Confidence interval) were 59.7% (39.7-89.6), 58.6% (38.7-88.8), and 69.4% (49.9-96.6). The median hospital stay was 21 days (IQR 17.0-23.5). Oral diet and decannulation were achieved after a median of 14 days (IQR 12.0-15.0). Feeding tube and tracheostomy dependence after 6 months was observed in 3 (15%) and 2 (10%) patients, respectively. Conclusions: The use of NCT followed by TORS for PPW SCC treatment appears to have good oncological and functional outcomes for both early and locally advanced cancers. Further randomized trials and site-specific guidelines are needed.
2023
head and neck neoplasm; Induction chemotherapy; neoadjuvant chemotherapy; posterior pharyngeal wall; robotic surgery; squamous cell carcinoma
01 Pubblicazione su rivista::01a Articolo in rivista
Neoadjuvant chemotherapy and transoral robotic surgery for the posterior pharyngeal wall carcinoma / Costantino, Andrea; Meliante, Piero Giuseppe; Sampieri, Claudio; Lee, Kyuin; Ralli, Massimo; De Vincentiis, Marco; De Virgilio, Armando; Kim, Se-Heon. - In: EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY AND HEAD & NECK. - ISSN 1434-4726. - 280:10(2023), pp. 4649-4655. [10.1007/s00405-023-08070-1]
File allegati a questo prodotto
File Dimensione Formato  
Costantino_Neoadjuvant chemotherapy_2023.pdf

solo gestori archivio

Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 745.55 kB
Formato Adobe PDF
745.55 kB Adobe PDF   Contatta l'autore

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1693663
Citazioni
  • ???jsp.display-item.citation.pmc??? 0
  • Scopus 1
  • ???jsp.display-item.citation.isi??? 0
social impact