Transoral robotic surgery for the identification of unknown primary head and neck squamous cell carcinomas: Its effect on the wait and the weight

Faisal Alzahrani, Axel Sahovaler, Neil Mundi, Almoaidbellah Rammal, Naif Fnais, S. Danielle MacNeil, Adrian Mendez, John Yoo, Kevin Fung, Francisco Laxague, Andrew Warner, David A. Palma, Anthony Nichols

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background: Neck carcinoma of unknown primary (CUP) is a frequent scenario. Transoral robotic mucosectomies (TORM) of pharynx have increased rate of primary identification, but come with cost of treatment delay. Methods: We reviewed patients who underwent CUP protocol from 2014 to 2020. Patients with cervical nodes carcinoma and failure to localize a primary source were classified as CUP. We determined primary identification rate and postoperative complications. Results: We included 65 patients underwent TORM. Surgical approach consisted of lingual and/or palatine tonsillectomies. The primary detection rate was 49.2%. Average weight reduction was 2.5 ± 4.3 kg. The average number of days from consultation to definitive treatment was 52.2 ± 18.3. Conclusion: A systematic approach to patients with CUP showed a promising primary identification rate compared to panendoscopy alone. TORM carries a small risk of complications. The benefits of primary identification must be weighed with the morbidity and delay to definitive treatment.

Original languageEnglish
Pages (from-to)1206-1212
Number of pages7
JournalHead and Neck
Volume44
Issue number5
DOIs
StatePublished - May 2022
Externally publishedYes

Keywords

  • carcinoma of unknown primary
  • complications
  • transoral robotic surgery
  • treatment delay
  • weight

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