Robotic surgery less invasive on HPV-related oral cancers

Robotic surgery conducted through patients' mouths provides excellent results in removing squamous cell carcinoma at the back of the throat, especially in patients with HPV, according to a new Mayo Clinic study (Mayo Clinic Proceedings, March 2012, Vol. 87(3), pp. 211-212).

"We were surprised that the cancer cure results were even better than the traditional treatments that we have been doing, but that is probably almost as much of a matter that these cancers are HPV-mediated for the most part, and they respond much better to treatment," said study author Eric Moore, MD, a head and neck surgeon at Mayo Clinic. "Importantly, the treatment preserved patients' ability to swallow, and their speech performance was excellent."

Dr. Moore and his team followed 66 patients with oropharyngeal cancer who underwent transoral robotic surgery with the da Vinci robotic surgical system. Every few months, the patients underwent imaging studies, scans, and exams to determine if cancer was recurring.

After two years, the researchers found that the patients' survival rates were greater than 92%, which is as high as some other surgical and nonsurgical treatments for oropharyngeal cancer.

Because traditional surgery techniques to remove throat tumors can be traumatic, requiring cutting and reconstructing the mandible, neck, and tongue, the researchers were also interested in patients' healing after robotic surgery.

"We found that with transoral robotic surgery, 96% of patients could swallow a normal diet within three weeks of treatment," Dr. Moore said. Less than 4% required a gastrostomy tube, he added.

The study provides preliminary data illustrating that the robotic surgery is a viable treatment option, Dr. Moore concluded. Continuing research involving multiple medical centers will investigate transoral robotic surgery in a larger population of patients with oropharyngeal cancer.

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