title: Mini-invasive lateral oropharyngectomy for T3-T4a oropharyngeal cancer.
abstract: Mandibular swing is the approach of choice for resection of advanced oropharyngeal carcinomas without bone involvement. This approach requires a mandibulotomy, which is associated with complications. A prospective outcome analysis was performed for 21 patients operated without mandibulotomy for T3-T4a oropharyngeal carcinoma. Tumour size was categorized as T3 in 14 patients (66.7 %) and as T4a (33.3 %) in 7 patients. Twelve patients were N0 (57.1 %), 2 (9.5 %) were N1, and 7 (33.3 %) were N2. Surgical margins were negative in 18 cases (85.7 %), positive in 1 (4.8 %), and close in 2 (9.5 %). Average hospital stay was 14.5 days (range 10-22). Adjuvant treatment (radiotherapy or concurrent chemoradiotherapy) was administered to all but three patients previously irradiated. In all cases radiotherapy started within 42 days of surgery. The 3-year overall survival was 85.7 %, and relapse-free survival was 71.4 %. Oropharyngectomy without mandibulotomy has the same indications as mandibular swing. It provides good access to achieve satisfactory clearance of tumours, sparing patients the morbidity associated with mandibulotomy.
authors.affiliation: Department of Head and Neck Surgery, CHU, Montpellier, France.
authors.forename: Pierfrancesco
authors.initials: P
authors.lastname: Pelliccia
authors.forename: Marcos
authors.initials: M
authors.lastname: Martinez Del Pero
authors.forename: Grégoire
authors.initials: G
authors.lastname: Mercier
authors.forename: Mohammad
authors.initials: M
authors.lastname: Al Felasi
authors.forename: Giorgio
authors.initials: G
authors.lastname: Iannetti
authors.forename: Michael
authors.initials: M
authors.lastname: Bartolomeo
authors.forename: Marc
authors.initials: M
authors.lastname: Makeieff
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000473:pathology / Q000601:surgery; D009959:Oropharyngeal Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D009960:Oropharynx / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D013524:Surgical Flaps