ICHNO-ECHNO 2022 - Abstract Book

S22

ICHNO-ECHNO 2022

Purpose or Objective Transoral robotic surgery for oropharyngeal carcinoma was developed to improve quality of life of patients compared to conventional open surgery. However, very few data are available in salvage surgery. We implemented six years ago robotic assistance in salvage surgery in oropharyngeal cancer when no bone resection is required. We analyzed our experience. Materials and Methods We reviewed patients operated between sept 2015 and sept 2021 of an oropharyngeal squamous cell carcinoma in a previously irradiated field, either due to failure of radiation treatment or a second primary. Surgery was limited to soft tissue without a need for mandibular resection and consisted of either transoral robotic surgery or a combined cervical- transoral robotic surgery depending on the size and depth of infiltration of the tumor, with or without concurrent flap reconstruction. We analyzed (1) perioperative outcomes using the rates of complications with the Clavien-Dindo classification, (2) functional results with tracheotomy, oral feeding, and evolution of MDADI score, (3) evolution of quality of life using QLQC30 score, and (4) oncological outcomes using surgical margins, overall survival (OS), disease-free survival (DFS) and local control (LC). Results During this period of time, 53 patients were operated (42M/11F). Mean age was 64 years (range, 37-87 years). 26 pts were former smokers and 20 were still active. 20 pts were former alcoholic and 10 were still active. The median Charlson comorbidity index was 5. Median time from previous radiotherapy was 2,561 days. Three patients had been reirradiated. 22.6% of pts had a T3-4 tumor. 86.8% were p16-negative. Five patients had a synchron second primary. 28 pts were operated for radiotherapy failure, 25 for second primary. 32.1% of pts were ASA 3 or 4. 12 pts underwent a pedicled flap, and 36 a free flap. Two patients died in postoperative complications. 36 patients had a Clavien-Dindo score of 1 or 2. All tracheotomized patients were successfully decannulated. 35.3% of patients still required enteral feeding at 6 months at least in complementation of oral feeding. Mean MDADI score were 71.3 before surgery, 64.8 at 6 months, 65.9 at 1 year, and 57.7 at 2 years. Mean QLQC30 scores were 62.3 before surgery, 57.8 at 6 months, 69.8 at 1 year, and 81.2 at 2 years. The mean tumor size was 24mm (range, 3-50mm) and the mean depth of infiltration was 9mm (range, 1-26mm). 81.1% of pts had a definitive R0 complete resection. Ten patients had nodal invasion, six with extranodal extension. The 2-year OS, DFS and LC were 58.5%, 45.8%, and 80.7%. variables associated with survival were margins status and extranodal extension. Conclusion Robotic-assisted salvage surgery for oropharyngeal carcinoma after radiation in a complex and an heavily pre-treated population resulted in limited rates of complications, encouraging functional outcomes, good quality of life preservation, and favorable oncological outcomes. 1 Bristol Cancer Institute, Clinical Oncology, Bristol, United Kingdom; 2 University of Bristol, Bristol Dental School, Bristol, United Kingdom Purpose or Objective The Head and Neck 5000 Project (HN5000) recruited over 5000 patients of all ages and Performance Score (PS), including those conventionally excluded from published trials. Our objective was to describe the demographics and patient related outcome measures (PROMs) of patients with larynx cancer treated radically with radiotherapy (RT) in the definitive or adjuvant setting. Materials and Methods The dataset from HN5000, a prospective clinical cohort of head and neck cancer patients was incorporated with RT data via linkage to the National Clinical Analysis and Specialised Applications Team dataset. Demographic data, cancer stage and treatment modalities were recorded. PROMs were recorded for all larynx patients and cross referenced with age and PS to look for impact of these factors. Individuals were included in analyses if all relevant data was present; those with missing data for the parameter of interest were excluded from that analysis. Results 1071 larynx cancer patients were included in this study, 85% were male. 65% of patients had early-stage disease, 33% had locally advanced disease. 35% were 70 years or older, 20% had a PS 2 or more. 818 patients received radical dose RT in the definitive or adjuvant setting. 99% of patients completed their RT course. Table 1: PROM for severity of hoarseness, swallow impairment and dry mouth according to age and PS. Number ( n) = x (% patients) OC-0037 Demographics & PROMS for real world larynx cancer patients: Data from the Head and Neck 5000 study S. Hargreaves 1,2