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Master Thesis

Résultats fonctionnels, oncologiques et complications de l’exérèse des carcinomes épidermoïdes oropharyngés par chirurgie transorale robot-assistée‎ : étude monocentrique prospective à propos de 32 cas

Abstract : BACKGROUND : Several studies had reported better early functional and oncologic outcomes than open surgeries or exclusive chemoradiation therapy (CRT)in treatment of oropharyngeal squamous cell carcinomas (OSCC). The purpose of this study was to compare our results to litterature. METHODS : In this is single-institution prospective study, 32 patients underwent TORS procedures during 27 months. RESULTS : 81% had an early T1T2 tumour. 37,5% undergone radiation therapy before TORS. The median duration of TORS was 64±31,3min with a significant decrease with experience after 10 procedures (80,5±40,1 VS 49±25, p=0,05). The median hospital stay was 22 ±9,4 days. The duration of nasogastric tube feeding was 21±16,1 days and was significantly higher in prior radiation patient (49±7,1 VS 15±6,9, p<0,02). Gastrostomy tube feeding was necessary for 8 patients (prior radiation therapy, T3, after adjuvant CRT). 5 pharyngeal bleeding required hemostasis surgery. 4 pharyngocutaneous fistulas, 6 aspiration pneumonias, 1 spondylitis and 6 deaths occurred. One patient undergone secondary tracheostomy for pharyngeal stenosis. The median follow-up was 16±7,9 months. Although surgical margin was invaded in 37,5%, none of the primary early oropharyngeal cancer had local recurrence. The disease-free survival rate was 91,7% at 12 months and 59% at 21 months and was decreasing in patients with prior radiation therapy (p=0,32). CONCLUSION : Our early functional and oncologic show that early primary can be treated only by TORS or with adjuvant raiotherapy with excellent outcomes. The multicenter study in progress could confirm those hopeful preliminary results by long term outcomes.
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Master Thesis
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Submitted on : Friday, November 13, 2015 - 12:28:14 PM
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  • HAL Id : dumas-01228558, version 1

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José Merrifield. Résultats fonctionnels, oncologiques et complications de l’exérèse des carcinomes épidermoïdes oropharyngés par chirurgie transorale robot-assistée‎ : étude monocentrique prospective à propos de 32 cas. Médecine humaine et pathologie. 2015. ⟨dumas-01228558⟩

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