Robotic surgery vs laser microsurgery in early-stage laryngeal cancer

  • Hanna J & al.
  • Laryngoscope
  • 24 Jun 2019

  • curated by Brian Richardson, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Transoral robotic surgery (TORS) is associated with similar margin status, need for adjuvant radiation, and OS as open partial surgery in patients with early-stage (T1/2) laryngeal squamous cell carcinoma (SCC), whereas transoral laser microsurgery (TLM) is associated with increased rates of positive margins and need for adjuvant radiation.

Why this matters

  • There are limited data on outcomes of TORS for laryngeal cancer, which is increasingly used and has potential for functional preservation.

Key results

  • TORS was associated with similar positive margin status as open surgery (OR, 1.18; 95% CI, 0.72-1.94).
    • TLM was associated with increased rates of positive margins compared with open surgery (OR, 1.63; 95% CI, 1.12-2.38).
  • TORS was associated with similar need for adjuvant radiation as open surgery (OR, 1.56; 95% CI, 0.97-2.49).
    • TLM was associated with increased need for adjuvant radiation compared with open surgery (OR, 1.52; 95% CI, 1.04-2.24).
  • Surgical approach was not significantly associated with OS (P=.37), although the study was not powered for survival analysis.

Study design

  • 1780 patients with T1/2 laryngeal SCC from the National Cancer Database, 10.4% who received TORS, 29.4% who received open surgery, and 60.2% who received TLM, were included.
  • Funding: None disclosed.

Limitations

  • Retrospective study of large database.