Transoral Robotic Surgery for Oral Cancer: Evaluating Surgical Outcomes in the Presence of Trismus
Trismus, defined as restricted mouth opening, is a common complication among Taiwanese oral cancer patients, especially those who chew betel quid. However, the impact of trismus on survival outcomes in oral cancer patients undergoing transoral robotic surgery (TORS) is unclear. This study aimed to i...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-03-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/16/6/1111 |
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| author | Ting-Shen Lin Ci-Wen Luo Tsai-Ling Hsieh Frank Cheau-Feng Lin Stella Chin-Shaw Tsai |
| author_facet | Ting-Shen Lin Ci-Wen Luo Tsai-Ling Hsieh Frank Cheau-Feng Lin Stella Chin-Shaw Tsai |
| author_sort | Ting-Shen Lin |
| collection | DOAJ |
| description | Trismus, defined as restricted mouth opening, is a common complication among Taiwanese oral cancer patients, especially those who chew betel quid. However, the impact of trismus on survival outcomes in oral cancer patients undergoing transoral robotic surgery (TORS) is unclear. This study aimed to investigate the associations between trismus and surgical outcomes in Taiwanese male oral cancer patients treated with TORS. We conducted a retrospective propensity score-matched cohort study of 40 Taiwanese male oral cancer patients who underwent TORS between 2016 and 2022. Overall, 20 patients with trismus were matched to 20 patients without trismus. TORS achieved similar operative and short-term clinical outcomes in trismus patients to non-trismus patients. There were no significant differences between groups in operation time, blood loss, margin status, flap reconstruction rates, duration of nasogastric tube feeding, or length of hospital stay. Kaplan–Meier and Cox proportional hazard regression analyses were performed to compare overall survival (OS) and disease-free survival (DFS) between the two groups. The overall survival (OS) rate at three years was significantly lower in patients with trismus than those without trismus (27.1% vs. 95.0%, log-rank <i>p</i> = 0.02). However, there was no significant difference in disease-free survival (DFS) rates between the trismus and non-trismus groups (36.6% vs. 62.7%, log-rank <i>p</i> = 0.87). After adjusting for confounders, trismus was independently associated with a 13-fold increased risk of mortality (adjusted HR 12.87, 95% CI 1.55–106.50, <i>p</i> < 0.05). In conclusion, trismus appears to be an independent prognostic factor for reduced long-term OS in Taiwanese male oral cancer patients undergoing TORS, though short-term surgical outcomes were non-inferior in the trismus patients. Further research is warranted to clarify the mechanisms linking trismus and survival in this population. |
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| id | doaj.art-7c8ee3cc94be4e06a785b65910b09a95 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-04-24T18:28:01Z |
| publishDate | 2024-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-7c8ee3cc94be4e06a785b65910b09a952024-03-27T13:29:51ZengMDPI AGCancers2072-66942024-03-01166111110.3390/cancers16061111Transoral Robotic Surgery for Oral Cancer: Evaluating Surgical Outcomes in the Presence of TrismusTing-Shen Lin0Ci-Wen Luo1Tsai-Ling Hsieh2Frank Cheau-Feng Lin3Stella Chin-Shaw Tsai4Department of Medical Education, Tungs’ Taichung MetroHarbor Hospital, Taichung 43503, TaiwanDepartment of Medical Research, Tungs’ Taichung MetroHarbor Hospital, Taichung 43503, TaiwanDepartment of Medical Research, Tungs’ Taichung MetroHarbor Hospital, Taichung 43503, TaiwanSchool of Medicine, Chung Shan Medical University, Taichung 40201, TaiwanDepartment of Otolaryngology, Tungs’ Taichung MetroHarbor Hospital, Taichung 43503, TaiwanTrismus, defined as restricted mouth opening, is a common complication among Taiwanese oral cancer patients, especially those who chew betel quid. However, the impact of trismus on survival outcomes in oral cancer patients undergoing transoral robotic surgery (TORS) is unclear. This study aimed to investigate the associations between trismus and surgical outcomes in Taiwanese male oral cancer patients treated with TORS. We conducted a retrospective propensity score-matched cohort study of 40 Taiwanese male oral cancer patients who underwent TORS between 2016 and 2022. Overall, 20 patients with trismus were matched to 20 patients without trismus. TORS achieved similar operative and short-term clinical outcomes in trismus patients to non-trismus patients. There were no significant differences between groups in operation time, blood loss, margin status, flap reconstruction rates, duration of nasogastric tube feeding, or length of hospital stay. Kaplan–Meier and Cox proportional hazard regression analyses were performed to compare overall survival (OS) and disease-free survival (DFS) between the two groups. The overall survival (OS) rate at three years was significantly lower in patients with trismus than those without trismus (27.1% vs. 95.0%, log-rank <i>p</i> = 0.02). However, there was no significant difference in disease-free survival (DFS) rates between the trismus and non-trismus groups (36.6% vs. 62.7%, log-rank <i>p</i> = 0.87). After adjusting for confounders, trismus was independently associated with a 13-fold increased risk of mortality (adjusted HR 12.87, 95% CI 1.55–106.50, <i>p</i> < 0.05). In conclusion, trismus appears to be an independent prognostic factor for reduced long-term OS in Taiwanese male oral cancer patients undergoing TORS, though short-term surgical outcomes were non-inferior in the trismus patients. Further research is warranted to clarify the mechanisms linking trismus and survival in this population.https://www.mdpi.com/2072-6694/16/6/1111trismusoral cancertransoral robotic surgery (TORS)overall survivaldisease-free survivalconcurrent chemoradiotherapy |
| spellingShingle | Ting-Shen Lin Ci-Wen Luo Tsai-Ling Hsieh Frank Cheau-Feng Lin Stella Chin-Shaw Tsai Transoral Robotic Surgery for Oral Cancer: Evaluating Surgical Outcomes in the Presence of Trismus Cancers trismus oral cancer transoral robotic surgery (TORS) overall survival disease-free survival concurrent chemoradiotherapy |
| title | Transoral Robotic Surgery for Oral Cancer: Evaluating Surgical Outcomes in the Presence of Trismus |
| title_full | Transoral Robotic Surgery for Oral Cancer: Evaluating Surgical Outcomes in the Presence of Trismus |
| title_fullStr | Transoral Robotic Surgery for Oral Cancer: Evaluating Surgical Outcomes in the Presence of Trismus |
| title_full_unstemmed | Transoral Robotic Surgery for Oral Cancer: Evaluating Surgical Outcomes in the Presence of Trismus |
| title_short | Transoral Robotic Surgery for Oral Cancer: Evaluating Surgical Outcomes in the Presence of Trismus |
| title_sort | transoral robotic surgery for oral cancer evaluating surgical outcomes in the presence of trismus |
| topic | trismus oral cancer transoral robotic surgery (TORS) overall survival disease-free survival concurrent chemoradiotherapy |
| url | https://www.mdpi.com/2072-6694/16/6/1111 |
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