TY - JOUR

T1 - Transoral robotic surgery for the management of head and neck squamous cell carcinoma of unknown primary

AU - Channir, Hani Ibrahim

AU - Rubek, Niclas

AU - Nielsen, Hans Ulrik

AU - Kiss, Katalin

AU - Charabi, Birgitte W

AU - Lajer, Christel B

AU - von Buchwald, Christian

PY - 2015

Y1 - 2015

N2 - CONCLUSION: The addition of transoral robotic surgery (TORS) in the diagnostic management of patients classified with head and neck squamous cell carcinoma of unknown primary (SCCUP) is promising and appears to improve detection rates of the primary tumour. The approach presented in this first Scandinavian study could potentially minimize the radiation field to the pharyngeal axis in patients with identified primary tumours.OBJECTIVES: The aim of the study was to investigate whether bilateral lingual tonsillectomy performed with TORS is feasible, and whether it could improve the detection rates of primary tumours in patients diagnosed and classified as having SCCUP.METHODS: The study was retrospective and included 13 patients with SCCUP who were referred to TORS between October 2013 and January 2015. All 13 patients had previously undergone a full investigation programme following the national guidelines including whole-body PET/CT, examination in general anaesthesia, including random biopsies of the base of the tongue and bilateral palatine tonsillectomy without identification of the primary tumour.RESULTS: The primary tumour was identified by TORS in seven of the 13 patients (54%) at the lingual tonsils. Human papillomavirus DNA and p16 were positive in all identified primary tumour specimens and in the corresponding lymph node metastases.

AB - CONCLUSION: The addition of transoral robotic surgery (TORS) in the diagnostic management of patients classified with head and neck squamous cell carcinoma of unknown primary (SCCUP) is promising and appears to improve detection rates of the primary tumour. The approach presented in this first Scandinavian study could potentially minimize the radiation field to the pharyngeal axis in patients with identified primary tumours.OBJECTIVES: The aim of the study was to investigate whether bilateral lingual tonsillectomy performed with TORS is feasible, and whether it could improve the detection rates of primary tumours in patients diagnosed and classified as having SCCUP.METHODS: The study was retrospective and included 13 patients with SCCUP who were referred to TORS between October 2013 and January 2015. All 13 patients had previously undergone a full investigation programme following the national guidelines including whole-body PET/CT, examination in general anaesthesia, including random biopsies of the base of the tongue and bilateral palatine tonsillectomy without identification of the primary tumour.RESULTS: The primary tumour was identified by TORS in seven of the 13 patients (54%) at the lingual tonsils. Human papillomavirus DNA and p16 were positive in all identified primary tumour specimens and in the corresponding lymph node metastases.

KW - Aged

KW - Carcinoma, Squamous Cell

KW - Female

KW - Head and Neck Neoplasms

KW - Humans

KW - Male

KW - Middle Aged

KW - Mouth

KW - Natural Orifice Endoscopic Surgery

KW - Neoplasm Staging

KW - Neoplasms, Unknown Primary

KW - Positron-Emission Tomography

KW - Retrospective Studies

KW - Robotics

KW - Tomography, X-Ray Computed

KW - Treatment Outcome

U2 - 10.3109/00016489.2015.1052983

DO - 10.3109/00016489.2015.1052983

M3 - Journal article

C2 - 26073750

VL - 135

SP - 1051

EP - 1057

JO - Acta Oto-Laryngologica

JF - Acta Oto-Laryngologica

SN - 0001-6489

IS - 10

ER -