Utilizing Trans-Oral Robotic Surgery (TORS) in head and neck malignancy – is it practical in oropharyngeal squamous cell carcinoma (OPSCC)? A case report
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- DOI: https://doi.org/10.15562/bmj.v12i1.3285 |
- Published: 2023-03-06
Open Access & Peer Reviewed Multidisciplinary
Journal of Medical Sciences
Journal of Medical Sciences
Abstract
Introduction: Oropharyngeal squamous cell carcinoma (OPSCC) is often managed by multimodal methods, including open surgical resection and reconstruction in advanced cases. Trans-oral Robotic Surgery (TORS) was introduced to minimize and avoid complications caused by the open surgery method and chemo-radiation therapy in treating oropharyngeal squamous cell carcinoma (OPSCC). In Malaysia, TORS is still a new, rare, and limited surgical technique practiced in our healthcare system.
Case Presentation: We present a case of the base of tongue lesion which presented with chronic globus sensation for four months associated with chronic dysphagia and cough. Endoscopy examination revealed a lobulated mass situated at the left side base of the tongue. Contrast Enhanced Computed Tomography (CECT) of the neck revealed an enhancing lesion at the same site. There were multiple subcentimeter cervical lymph nodes bilaterally from level II to level V. The patient underwent a TORS procedure using the da Vinci Surgery System for incisional biopsy. By using TORS, we were able to obtain a good tumor sample including the margins for the biopsy. Histopathology examination (HPE) of the sample reported moderate to poorly differentiated squamous cell carcinoma. Based on the HPE and CECT results, the patient was diagnosed with oropharyngeal squamous cell carcinoma (OPSCC) with a clinical stage of T3N2cMx.
Conclusion: Management strategies for patients with OPSCC continue to evolve to minimize the morbidities and complications of treatments. Minimally invasive surgical techniques such as TORS offer impressive functional and oncologic outcomes particularly for patients (therapeutic function) compared to the traditional method of treatments.
References
- Kelly, K., et al., Oncologic, functional and surgical outcomes of primary Transoral Robotic Surgery for early squamous cell cancer of the oropharynx: A systematic review. Oral Oncology, 2014. 50(8): p. 696-703.
- Dowthwaite, S.A., et al., The role of transoral robotic surgery in the management of oropharyngeal cancer: a review of the literature. International Scholarly Research Notices, 2012. 2012.
- Duek, I., et al., Transoral robotic surgery in the HPV era. Rambam Maimonides medical journal, 2014. 5(2).
- Li, H., et al., Clinical value of transoral robotic surgery: nationwide results from the first 5 years of adoption. The Laryngoscope, 2019. 129(8): p. 1844-1855.
- D’Souza, G., et al., Differences in the Prevalence of Human Papillomavirus (HPV) in Head and Neck Squamous Cell Cancers by Sex, Race, Anatomic Tumor Site, and HPV Detection Method. JAMA Oncology, 2017. 3(2): p. 169-177.
- Sload, R., et al., The role of transoral robotic surgery in the management of HPV negative oropharyngeal squamous cell carcinoma. Current oncology reports, 2016. 18(9): p. 1-8.
- Chillakuru, Y., et al., Transoral robotic surgery versus nonrobotic resection of oropharyngeal squamous cell carcinoma. Head & Neck, 2021.
- Baskin, R.M., et al., Transoral robotic surgery for oropharyngeal cancer: patient selection and special considerations. Cancer management and research, 2018. 10: p. 839.
- Nichols, A.C., et al., Early-stage squamous cell carcinoma of the oropharynx: radiotherapy vs. trans-oral robotic surgery (ORATOR)–study protocol for a randomized phase II trial. BMC cancer, 2013. 13(1): p. 1-9.
- Park, Y.M., et al., Transoral robotic surgery-based therapy in patients with stage III-IV oropharyngeal squamous cell carcinoma. Oral oncology, 2017. 75: p. 16-21.
- Dziegielewski, P.T., et al., Transoral robotic surgery for oropharyngeal cancer: long-term quality of life and functional outcomes. JAMA otolaryngology–head & neck surgery, 2013. 139(11): p. 1099-1108.
How to Cite
Fakhruzzaman, M. S., Khalid, A. K., Abd Halim, H., & Yunus, M. R. (2023). Utilizing Trans-Oral Robotic Surgery (TORS) in head and neck malignancy – is it practical in oropharyngeal squamous cell carcinoma (OPSCC)? A case report. Bali Medical Journal, 12(1), 930–933. https://doi.org/10.15562/bmj.v12i1.3285
