caa a22 4500 606186808 CHVBK 20210128100838.0 cr unu---uuuuu 210128e20150201xx s 000 0 eng 10.1007/s00405-014-2985-7 doi (NATIONALLICENCE)springer-10.1007/s00405-014-2985-7 Functional outcomes after TORS for oropharyngeal cancer: a systematic review [Elektronische Daten] [Katherine Hutcheson, F. Holsinger, Michael Kupferman, Jan Lewin] Summarize functional outcomes after transoral robotic surgery (TORS)±adjuvant therapy for oropharyngeal cancer (OPC). A systematic review was conducted. The MEDLINE database was searched (MeSH terms: TORS, pharyngeal neoplasms, oropharyngeal neoplasms). Peer-reviewed human subject papers published through December 2013 were included. Exclusion criteria were as follows: (1) case report design (n<10), (2) review article, or (3) technical, animal, or cadaver studies. Functional outcomes extracted included feeding tube dependence, swallow examination findings, speech ratings, velopharyngeal insufficiency, pneumonia, and oral intake measures. Twelve papers comprising 441 patients with OPC treated with TORS±adjuvant therapy were included. Feeding tube rates were the most commonly reported functional outcome. Excluding prophylactic placement, 18-39% of patients required gastrostomy placement, typically during adjuvant therapy. Chronic gastrostomy dependence ranged from 0 to 7% (mean follow-up 11-26months), regardless of disease stage. Composite MD Anderson Dysphagia Inventory (MDADI) scores ranged from 65.2 to 78 (89 patients, 3 series, mean follow-up 12-13months). Videofluoroscopic swallowing studies were not systematically reported. Incidence of postoperative pneumonia was 0-7%. Predictors of swallowing function included baseline function, T-stage, N-stage, tongue base primary tumors, and adjuvant chemoradiation. Rates of transient hypernasality were 4-9%. A single study suggested dose-dependent effects of adjuvant therapy (none, radiation alone, chemoradiation) on diet scores at 6 and 12 months. Crude end points of functional recovery after TORS±adjuvant therapy suggest promising swallowing outcomes, depending on the functional measure reported. Springer-Verlag Berlin Heidelberg, 2014 Transoral robotic surgery nationallicence Oropharyngeal cancer nationallicence Functional outcome nationallicence Swallowing nationallicence TORS : Transoral robotic surgery nationallicence IMRT : Intensity-modulated radiotherapy nationallicence Hutcheson Katherine Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1445, 77030, Houston, TX, USA aut Holsinger F. Department of Otolaryngology-Head and Neck Surgery, Stanford School of Medicine, Stanford, CA, USA aut Kupferman Michael Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1445, 77030, Houston, TX, USA aut Lewin Jan Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1445, 77030, Houston, TX, USA aut European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/2(2015-02-01), 463-471 0937-4477 272:2<463 2015 272 405 https://doi.org/10.1007/s00405-014-2985-7 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00405-014-2985-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Hutcheson Katherine Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1445, 77030, Houston, TX, USA aut NATIONALLICENCE 700 1- Holsinger F. Department of Otolaryngology-Head and Neck Surgery, Stanford School of Medicine, Stanford, CA, USA aut NATIONALLICENCE 700 1- Kupferman Michael Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1445, 77030, Houston, TX, USA aut NATIONALLICENCE 700 1- Lewin Jan Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1445, 77030, Houston, TX, USA aut NATIONALLICENCE 773 0- European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/2(2015-02-01), 463-471 0937-4477 272:2<463 2015 272 405