(105) Comparative Survival Analysis of Transoral Robotic Resection of Glottic SCC

Introduction: Transoral roboticsurgery (TORS) has been increasingly used as a minimally invasive approach for cancers of the upper aerodigestive tract. Though its use for oropharynx and supraglottic tumors is well established, data regarding its efficacy for glottic tumors are scarce. The aim of this National Cancer Database (NCDB) review is to analyze data regarding the use of TORS in glottic cancers with particular emphasis on survival outcomes.

Methods: This is a retrospective NCDB review of glottic squamous cell carcinoma between 2010 and 2019..Clinicodemographic characteristics, including TNM staging, patient comorbid status, and treatment rendered, were collected. A multivariable Cox regression model was fit to assess predictors of overall survival, and, specifically to evaluate survival implications of a TORS approach.

Results: Study population included 46,781 glottic cancer patients. A total of 100 patients (0.19% of all patients) underwent a robotic surgical approach. Transoral laser microsurgery was the only surgical modality (HR=0.488; 95% CI 0.297-0.800) conveying an overall survival benefit, though there was a trend towards improved overall survival (HR=0.747; 95% CI 0.308-1.806) among TORS patients. There was no significant increase in the incidence of robotic surgical glottic cancer resections by year.

Conclusions: TORS conveys important benefits for exposure and ergonomics in the management of head and neck tumors. This preliminary analysis stipulates that TORS has been used in a small minority of glottic cancer cases nationally, but may represent an oncologically tenable approach. Prospective studies meant to compare TORS to more common treatment modalities are necessary to ascertain he value of TORS in the treatment of glottic cancer.