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Transoral robotic tongue base mucosectomy for head and neck cancer of unknown primary: six-year outcome experience

Published online by Cambridge University Press:  15 December 2023

Bassem Mettias Open the ORCID record for Bassem Mettias [Opens in a new window] ,
Hazem Nijim ,
David Laugharne  and
Sean Mortimore
Bassem Mettias*
Affiliation:
Department of Otolaryngology & Head and Neck Surgery Mid and South Essex NHS Foundation trust, Basildon, SS16 5NL, UK
Hazem Nijim
Affiliation:
Department of Otolaryngology & Head and Neck Surgery Mid and South Essex NHS Foundation trust, Basildon, SS16 5NL, UK
David Laugharne
Affiliation:
Royal Derby Hospital, University Hospitals of Derby and Burton NHS Trust, Uttoxeter Rd, Derby, DE22 3NE, UK
Sean Mortimore
Affiliation:
Department of Otolaryngology & Head and Neck Surgery Mid and South Essex NHS Foundation trust, Basildon, SS16 5NL, UK
*
Corresponding author: Bassem Mettias; Email: bassemadel@hotmail.com
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Abstract

Background and Objective

Head and neck carcinoma of unknown primary is a diagnostic dilemma. The clinical and imaging workup remains ineffective in two-thirds of patients. Transoral robotic surgery has shown an advantage in the primary detection over the previous standard panendoscopy.

Methods

This is an observational cohort study that took place at a large healthcare centre with robotic surgery experience in head and neck over six-years. All included carcinoma of unknown primary patients followed the standard recommendation for primary identification. Final diagnostic step of robotic tongue base mucosectomy with or without tonsillectomy was introduced. The cancer detection rate in tongue base only, the functional outcome and the effect on the cancer pathway were evaluated.

Results

Carcinoma of unknown primary was reported in 44 per cent of patients. All identified specimens were human papillomavirus positive. There was no significant effect on functional outcome of swallowing and the national 62-day cancer pathway. Robotic surgery allowed optimum treatment of carcinoma of unknown primary in early nodal disease.

Conclusion

Robotic surgery is a useful paradigm in the management of carcinoma of unknown primary. It is safe with minimal morbidity and good functional outcome after the surgery.

Keywords

Roboticscarcinomaheadneck

Information

Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 138 , Issue 5 , May 2024 , pp. 548 - 553
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Bassem Mettias takes responsibility for the integrity of the content of the paper

“Thinking outside the box” event, Poster in Royal Society of Medicine meeting, 2 December 2022, London, UK.

Presented at BACO International 2023, 16 February 2023, Birmingham, UK.

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