Functional and quality-of-life outcomes of transoral robotic surgery for carcinoma of unknown primary.
OBJECTIVE
To determine speech, eating, aesthetics, social disruption, and overall quality-of-life outcomes over a year period in patients who underwent transoral robotic surgery as part of carcinoma of unknown primary diagnosis and treatment.


METHODS
Observational prospective study.


METHODS
Twenty-two patients who underwent transoral robotic surgery for the management of carcinoma of unknown primary were included. Patients prospectively completed the Head and Neck Cancer Inventory during a preoperative visit, and at 3-week, 3-month, 6-month, and 12-month postoperative visits. Patients' demographic, pathological, and follow-up information were also collected.


RESULTS
The mean follow-up time was 19.8 months. There were overall declines in all quality of life scores during treatment period, which was followed by a continuous recovery. The scores immediately after transoral robotic surgery (3 weeks) were significantly higher than the scores after conclusion of adjuvant therapy (3 months) in multiple domains (P < .05) and the 6-month scores in speech (P = .02) and eating (P = .008) domains. All scores, except for eating (P = .01) returned to pretreatment levels at 1 year. Patients with detected primaries displayed similar quality-of-life scores compared to patients with occult primaries. Human papillomavirus status and type of adjuvant treatment had no significant impact on quality of life.


CONCLUSIONS
Transoral robotic surgery is a promising, minimally invasive procedure for the surgical management of carcinoma of unknown primary. Patients maintain high functional and quality-of-life status at 1 year after surgery.
Department of Otolaryngology-Head and Neck Surgery, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Comprehensive Cancer Center, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.
Kasim
K
Durmus
Hafiz S
HS
Patwa
Hamza N
HN
Gokozan
Cuneyt
C
Kucur
Theodoros N
TN
Teknos
Amit
A
Agrawal
Matthew O
MO
Old
Enver
E
Ozer
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000556:secondary / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009055:Mouth; D009382:Neoplasms, Unknown Primary / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D012371:Robotics / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
Transoral robotic surgery; carcinoma of unknown primary; neck metastasis; quality of life; transoral robotic surgery