Ninety-day mortality following transoral robotic surgery or radiation at Commission on Cancer-accredited facilities

James R. Janopaul-Naylor; Manali Rupji; Rachel A. Tobillo; Joshua W. Lorenz; Jeffrey M. Switchenko; Sibo Tian; Azeem S. Kaka; David C. Qian; Ashley J. Schlafstein; Conor E. Steuer; Jill S. Remick; Soumon Rudra; Mark W. McDonald; Nabil F. Saba; William A. Stokes; Mihir R. Patel; James E. Bates

doi:10.1002/hed.27282

Ninety-day mortality following transoral robotic surgery or radiation at Commission on Cancer-accredited facilities

James R. Janopaul-Naylor, Manali Rupji, Rachel A. Tobillo, Joshua W. Lorenz, Jeffrey M. Switchenko, Sibo Tian, Azeem S. Kaka, David C. Qian, Ashley J. Schlafstein, Conor E. Steuer, Jill S. Remick, Soumon Rudra, Mark W. McDonald, Nabil F. Saba, William A. Stokes, Mihir R. Patel, James E. Bates

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Postoperative mortality for oropharynx squamous cell carcinoma (OPSCC) with transoral robotic surgery (TORS) varies from 0.2% to 6.5% on trials; the real-world rate is unknown. Methods: NCDB study from 2010 to 2017 for patients with cT1-2N0-2M0 OPSCC with Charleson–Deyo score 0–1. Ninety-day mortality assessed from start and end of treatment at Commission on Cancer-accredited facilities. Results: 3639 patients were treated with TORS and 1937 with radiotherapy. TORS cohort had more women and higher income, was younger, more often treated at academic centers, and more likely to have private insurance (all p < 0.05). Ninety-day mortality was 1.3% with TORS and 0.7% or 1.4% from start or end of radiotherapy, respectively. From end of therapy, there was no significant difference on MVA between treatment modality. Conclusions: There is minimal difference between 90-day mortality in patients treated with TORS or radiotherapy for early-stage OPSCC. While overall rates are low, for patients with expectation of cure, work is needed to identify optimal treatment.

Original language	English (US)
Pages (from-to)	658-663
Number of pages	6
Journal	Head and Neck
Volume	45
Issue number	3
DOIs	https://doi.org/10.1002/hed.27282
State	Published - Mar 2023
Externally published	Yes

Keywords

90-day mortality
organ preservation
oropharynx cancer
postoperative mortality
radiotherapy
transoral robotic surgery

ASJC Scopus subject areas

Otorhinolaryngology

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10.1002/hed.27282

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Janopaul-Naylor, J. R., Rupji, M., Tobillo, R. A., Lorenz, J. W., Switchenko, J. M., Tian, S., Kaka, A. S., Qian, D. C., Schlafstein, A. J., Steuer, C. E., Remick, J. S., Rudra, S., McDonald, M. W., Saba, N. F., Stokes, W. A., Patel, M. R., & Bates, J. E. (2023). Ninety-day mortality following transoral robotic surgery or radiation at Commission on Cancer-accredited facilities. Head and Neck, 45(3), 658-663. https://doi.org/10.1002/hed.27282

Janopaul-Naylor, JR, Rupji, M, Tobillo, RA, Lorenz, JW, Switchenko, JM, Tian, S, Kaka, AS, Qian, DC, Schlafstein, AJ, Steuer, CE, Remick, JS, Rudra, S, McDonald, MW, Saba, NF, Stokes, WA, Patel, MR & Bates, JE 2023, 'Ninety-day mortality following transoral robotic surgery or radiation at Commission on Cancer-accredited facilities', Head and Neck, vol. 45, no. 3, pp. 658-663. https://doi.org/10.1002/hed.27282

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title = "Ninety-day mortality following transoral robotic surgery or radiation at Commission on Cancer-accredited facilities",

abstract = "Background: Postoperative mortality for oropharynx squamous cell carcinoma (OPSCC) with transoral robotic surgery (TORS) varies from 0.2% to 6.5% on trials; the real-world rate is unknown. Methods: NCDB study from 2010 to 2017 for patients with cT1-2N0-2M0 OPSCC with Charleson–Deyo score 0–1. Ninety-day mortality assessed from start and end of treatment at Commission on Cancer-accredited facilities. Results: 3639 patients were treated with TORS and 1937 with radiotherapy. TORS cohort had more women and higher income, was younger, more often treated at academic centers, and more likely to have private insurance (all p < 0.05). Ninety-day mortality was 1.3% with TORS and 0.7% or 1.4% from start or end of radiotherapy, respectively. From end of therapy, there was no significant difference on MVA between treatment modality. Conclusions: There is minimal difference between 90-day mortality in patients treated with TORS or radiotherapy for early-stage OPSCC. While overall rates are low, for patients with expectation of cure, work is needed to identify optimal treatment.",

keywords = "90-day mortality, organ preservation, oropharynx cancer, postoperative mortality, radiotherapy, transoral robotic surgery",

author = "Janopaul-Naylor, {James R.} and Manali Rupji and Tobillo, {Rachel A.} and Lorenz, {Joshua W.} and Switchenko, {Jeffrey M.} and Sibo Tian and Kaka, {Azeem S.} and Qian, {David C.} and Schlafstein, {Ashley J.} and Steuer, {Conor E.} and Remick, {Jill S.} and Soumon Rudra and McDonald, {Mark W.} and Saba, {Nabil F.} and Stokes, {William A.} and Patel, {Mihir R.} and Bates, {James E.}",

note = "Publisher Copyright: {\textcopyright} 2022 Wiley Periodicals LLC.",

year = "2023",

month = mar,

doi = "10.1002/hed.27282",

language = "English (US)",

volume = "45",

pages = "658--663",

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T1 - Ninety-day mortality following transoral robotic surgery or radiation at Commission on Cancer-accredited facilities

AU - Janopaul-Naylor, James R.

AU - Rupji, Manali

AU - Tobillo, Rachel A.

AU - Lorenz, Joshua W.

AU - Switchenko, Jeffrey M.

AU - Tian, Sibo

AU - Kaka, Azeem S.

AU - Qian, David C.

AU - Schlafstein, Ashley J.

AU - Steuer, Conor E.

AU - Remick, Jill S.

AU - Rudra, Soumon

AU - McDonald, Mark W.

AU - Saba, Nabil F.

AU - Stokes, William A.

AU - Patel, Mihir R.

AU - Bates, James E.

PY - 2023/3

Y1 - 2023/3

N2 - Background: Postoperative mortality for oropharynx squamous cell carcinoma (OPSCC) with transoral robotic surgery (TORS) varies from 0.2% to 6.5% on trials; the real-world rate is unknown. Methods: NCDB study from 2010 to 2017 for patients with cT1-2N0-2M0 OPSCC with Charleson–Deyo score 0–1. Ninety-day mortality assessed from start and end of treatment at Commission on Cancer-accredited facilities. Results: 3639 patients were treated with TORS and 1937 with radiotherapy. TORS cohort had more women and higher income, was younger, more often treated at academic centers, and more likely to have private insurance (all p < 0.05). Ninety-day mortality was 1.3% with TORS and 0.7% or 1.4% from start or end of radiotherapy, respectively. From end of therapy, there was no significant difference on MVA between treatment modality. Conclusions: There is minimal difference between 90-day mortality in patients treated with TORS or radiotherapy for early-stage OPSCC. While overall rates are low, for patients with expectation of cure, work is needed to identify optimal treatment.

AB - Background: Postoperative mortality for oropharynx squamous cell carcinoma (OPSCC) with transoral robotic surgery (TORS) varies from 0.2% to 6.5% on trials; the real-world rate is unknown. Methods: NCDB study from 2010 to 2017 for patients with cT1-2N0-2M0 OPSCC with Charleson–Deyo score 0–1. Ninety-day mortality assessed from start and end of treatment at Commission on Cancer-accredited facilities. Results: 3639 patients were treated with TORS and 1937 with radiotherapy. TORS cohort had more women and higher income, was younger, more often treated at academic centers, and more likely to have private insurance (all p < 0.05). Ninety-day mortality was 1.3% with TORS and 0.7% or 1.4% from start or end of radiotherapy, respectively. From end of therapy, there was no significant difference on MVA between treatment modality. Conclusions: There is minimal difference between 90-day mortality in patients treated with TORS or radiotherapy for early-stage OPSCC. While overall rates are low, for patients with expectation of cure, work is needed to identify optimal treatment.

KW - 90-day mortality

KW - organ preservation

KW - oropharynx cancer

KW - postoperative mortality

KW - radiotherapy

KW - transoral robotic surgery

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Ninety-day mortality following transoral robotic surgery or radiation at Commission on Cancer-accredited facilities

Abstract

Keywords

ASJC Scopus subject areas

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