[Evaluation of quality of life and swallowing in patients with cancer of the oropharynx treated with assisted transoral robotic surgery].
OBJECTIVE
To present the preliminary results of the qualiit of life and quality of swallowing in a series of 15 patien! treated with oropharyngectomy by transoral robotic-assisted (CTAR) (robot da Vinci, Intuitive Surgical ).


METHODS
A prospective monocentric non-randomized study of 15 patients with cancer of the oropharynx. Were analyzed: demographics, quality of life questionnaires (QLQ-C30 and H&N 35 EORTC) and quality of swallowing questionnairex (MDADI, DHI and EAT 10) with an average of 1 year after the end of the treatment.


RESULTS
Fifteen patients (10 males and 5 females), mean age of 65 years (47-73 years) were included. The tumours were classified as: cT1: 4; cT2: 10 cT3: 1. Five of the 15 patients received postoperative chemoradiotherapy as histo-pathological studies showed multiple metastatic cervical lymph nodes +/- capsular rupture. For the analysis of the quality of life and quality of swallowing, the patients were divided into two groups. Group A included patients who underwent CTARs and group B, patients operated by CTAR with adjuvant chemoradiotherapy. At 12 months of the procedure, all patients had a deglutition considered as normal without feeding tube nor tracheostomy. With the three scales used, the quality of swallowing was satisfactory for all patients. It was better for patients in group A than for patients in group B. In terms of quality of life, the EORTC QLQ-C30 scale showed our patients had a high rate of satisfaction scale in "health and overall quality of life". For the EORTC H&N35 questionnaire, mean scores for "specific symptoms" were also low except for the following three items "dry mouths", "sticky saliva" and "sexuality problem". The first two items were statistically more frequent (p = 0.02 and p = 0.001) in group B patients.


CONCLUSIONS
After transoral robotic-assisted oropharyngectomy, patients have a good quality of life and swallowing. Postoperative chemoradio-therapy compromises the quality of swallowing. Multicentric studies are required to confirm these preliminary results.
Hôpital Européen Georges Pompidou, Department of Otolaryngology, Head and Neck Surgery, 20 rue Leblanc, 75015 Paris, France. stephane.hans@egp.aphp.fr
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Hans
Hôpital Européen Georges Pompidou, Department of Otolaryngology, Head and Neck Surgery, 20 rue Leblanc, 75015 Paris, France.
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Hoffman
Hôpital Européen Georges Pompidou, Department of Otolaryngology, Head and Neck Surgery, 20 rue Leblanc, 75015 Paris, France.
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Croidieu
Hôpital Européen Georges Pompidou, Department of Otolaryngology, Head and Neck Surgery, 20 rue Leblanc, 75015 Paris, France.
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Vialatte de Pemille
Hôpital Européen Georges Pompidou, Department of Otolaryngology, Head and Neck Surgery, 20 rue Leblanc, 75015 Paris, France.
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Crevier-Buchman
Hôpital Européen Georges Pompidou, Department of Otolaryngology, Head and Neck Surgery, 20 rue Leblanc, 75015 Paris, France.
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Monfrais-Pfauwadel
Hôpital Européen Georges Pompidou, Department of Otolaryngology, Head and Neck Surgery, 20 rue Leblanc, 75015 Paris, France.
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Menard
Hôpital Européen Georges Pompidou, Department of Otolaryngology, Head and Neck Surgery, 20 rue Leblanc, 75015 Paris, France.
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Brasnu
D000368:Aged; D003679:Deglutition / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D011788:Quality of Life; D012371:Robotics; D011795:Surveys and Questionnaires