title: Two-Year Survival Analysis of 50 Consecutive Head and Neck Cancer Patients Treated with Transoral Robotic Surgery in a Single European Centre.
abstract: BACKGROUND
  To date, this prospective cohort study is the largest of its kind from a single European academic tertiary care center to report 2-year survival outcomes for head and neck squamous cell carcinoma treated primarily with transoral robotic-assisted resection.
  
  
  METHODS
  Fifty consecutive, appropriately staged patients were enrolled prospectively, and underwent transoral robotic surgery (TORS) between September 2011 and August 2013. Overall, 24 patients had a T1 primary tumor, 23 had a T2 primary tumor, 2 had a T3 primary tumor, and 1 had a T4a primary tumor. Eighteen patients had overall stage I-II disease, and 32 patients had stage III-IV disease. Following transoral robotic resection of their primaries and appropriate neck dissection(s) as indicated, adjuvant treatment could be spared for 20 patients; another 5 patients refused the recommended adjuvant treatment. Seventeen patients received 60 Gy adjuvant radiotherapy and 8 patients underwent 66 Gy adjuvant chemoradiotherapy.
  
  
  RESULTS
  At the time of the last follow-up visit (median 27 months), overall survival was 94 %, with two disease-specific deaths and one unrelated death (heart attack). The 2-year disease-free and recurrence-free survival rates were 88 and 80 %, respectively; however, the local recurrence rate was only 10 % after 2 years.
  
  
  CONCLUSIONS
  Using TORS as their primary modality, 40 % of patients did not need adjuvant treatment and showed similar survival rates to that of conventional surgery or primary chemoradiotherapy. In another 34 % of patients, adjuvant chemotherapy could be spared and adjuvant radiotherapy could be reduced by 10 Gy compared with primary chemoradiotherapy of 70 Gy. Further studies are warranted with respect to long-term survival.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery and Oncology, Head and Neck Cancer Centre of the Hubertus Wald University Cancer Centre Hamburg, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany. b.loerincz@uke.de.
authors.forename: Balazs B
authors.initials: BB
authors.lastname: Lörincz
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery and Oncology, Head and Neck Cancer Centre of the Hubertus Wald University Cancer Centre Hamburg, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Möckelmann
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery and Oncology, Head and Neck Cancer Centre of the Hubertus Wald University Cancer Centre Hamburg, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Chia-Jung
authors.initials: CJ
authors.lastname: Busch
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery and Oncology, Head and Neck Cancer Centre of the Hubertus Wald University Cancer Centre Hamburg, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Adrian
authors.initials: A
authors.lastname: Münscher
authors.affiliation: Department of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Sehner
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery and Oncology, Head and Neck Cancer Centre of the Hubertus Wald University Cancer Centre Hamburg, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Carsten V
authors.initials: CV
authors.lastname: Dalchow
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery and Oncology, Head and Neck Cancer Centre of the Hubertus Wald University Cancer Centre Hamburg, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany. r.knecht@uke.de.
authors.forename: Rainald
authors.initials: R
authors.lastname: Knecht
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000401:mortality*; D009367:Neoplasm Staging; D013517:Otorhinolaryngologic Surgical Procedures / Q000401:mortality*; D011379:Prognosis; D011446:Prospective Studies; D065287:Robotic Surgical Procedures / Q000401:mortality*; D015996:Survival Rate; D013997:Time Factors