Traditional transoral approach and lateral pharyngotomy in surgical treatment of T1–2 oropharyngeal cancer

Introduction. Growing incidence of oropharyngeal cancer is one of the reasons for increased interest in possibilities of surgical treatment of this pathology which currently is associated with not always available robot-assisted interventions. Therefore, study of the efficacy of traditional surgical accesses is of certain interest.

Aim. To analyze the effectiveness of transoral access and lateral pharyngotomy in T1–2 squamous cell oropharyngeal cancer.

Materials and methods. The study included 74 patients, ages between 34 and 74 years (mean age 55.3 ± 9.1), with squamous cell carcinoma of the palatine tonsils and root of the tongue. In 38 cases, primary tumor was resected through transoral access (group 1); in 36 cases, using lateral pharyngotomy (group 2). Analysis of postoperative period included evaluation of the number and type of complications, number of repeat surgical interventions, duration of tube feeding and hospitalization. Treatment efficacy was determined taking into account the incidence of local and regional recurrences, locoregional control, and overall survival.

Results. Complication rate, mean tube feeding and hospitalization times in the 2nd group were significantly higher than in the 1st group: 36 % versus 3 %, 14.3 days versus 10.6 days and 17.0 days versus 10.4 days, respectively. No differences between the numbers of repeat surgeries and cases of salivary fistula formation were found. With median follow-up of 47 (4–122) months, rates of local and regional recurrences in the 1st and 2nd groups were 11 and 11 %, 11 and 13 %, respectively. In group 1, locoregional control was achieved in 84 % patients; in group 2, in 81 %. Distant metastases were diagnosed in 8 and 17 % cases, respectively. There were no statistically significant differences in this parameter between the groups. Five-year overall survival in the total cohort was 71.2 %.

Conclusion. The use of transoral access and lateral pharyngotomy in T1–2 oropharyngeal cancer is characterized by relatively high efficacy and acceptable rate of postoperative complications.