Transoral Robotic Surgery (TORS) is utilized for treating various malignancies, such as early-stage oropharyngeal cancer and lymph node metastasis of an unknown primary tumor (CUP), and also benign conditions, like obstructive sleep apnea (OSA) and chronic lingual tonsillitis. However, the success and failure of TORS have not been analyzed to date. In this retrospective observational multicenter cohort study, we evaluated patients treated with TORS using the da Vinci surgical system. Success criteria were defined as identification of the primary tumor for CUP, >2 mm resection margin for malignant conditions, and improvement on respiratory polygraphy and tonsillitis complaints for benign conditions. A total of 220 interventions in 211 patients were included. We identified predictors of success, such as low comorbidity status ACE-27, positive P16 status, and lower age for CUP, and female gender and OSA severity for benign conditions. For other malignancies, no predictors for success were found. Predictors of failure based on postoperative complications included high comorbidity scores (ASA) and anticoagulant use, and for postoperative pain, younger age and female gender were identified. This study provides valuable insights into the outcomes and predictors of success and failure in TORS procedures across various conditions and may also help in patient selection and counseling.
经口机器人手术（TORS）被用于治疗多种恶性肿瘤，如早期口咽癌和原发灶不明（CUP）的淋巴结转移，以及良性病症，如阻塞性睡眠呼吸暂停（OSA）和慢性舌扁桃体炎。然而，迄今为止，TORS的成功与失败尚未得到分析。在这项回顾性观察性多中心队列研究中，我们评估了使用达芬奇手术系统接受TORS治疗的患者。成功标准定义为：对于CUP患者，成功识别原发肿瘤；对于恶性病症，切除边缘大于2毫米；对于良性病症，呼吸多导图改善及扁桃体炎症状缓解。研究共纳入211名患者的220次干预。我们确定了成功的预测因素，例如对于CUP患者，较低的合并症状态ACE-27、P16阳性状态和较低年龄；对于良性病症，女性性别和OSA严重程度。对于其他恶性肿瘤，未发现成功的预测因素。基于术后并发症的失败预测因素包括高合并症评分（ASA）和抗凝药物使用；对于术后疼痛，年轻年龄和女性性别被确定为预测因素。这项研究为不同病症下TORS手术的结果及成功与失败的预测因素提供了有价值的见解，也可能有助于患者选择和咨询。
肿瘤(癌症)患者之家