Muscle invasion in oropharyngeal carcinoma undergoing transoral robotic surgery

Head Neck. 2021 Apr;43(4):1194-1201. doi: 10.1002/hed.26582. Epub 2020 Dec 23.

Abstract

Backgrounds: Pathologic features of oropharyngeal squamous cell carcinoma (OPSCC) treated with trans-oral robotic surgery predict prognosis and adjuvant therapy. We hypothesized that pathologic muscle invasion (pMI) is associated with poor pathological markers.

Methods: Retrospective review of surgically treated OPSCC to identify pMI and its association with poor pathologic markers.

Results: pMI was present in 12/37 patients, and compared to non-pMI, was associated with higher rates of lymphovascular invasion (75% vs. 36%, p = 0.03), perineural invasion (16.7% vs. 0%, p = 0.04), extranodal extension (66.7% vs. 20%, p < 0.01), and tumor stage (8.3% vs. 48% pT1, 75% vs. 52% pT2 and 16.7% vs. 0% pT3). pMI was associated with having a positive margin on main specimen (41.7% vs. 12%, p = 0.04) but not after considering additional margins.

Conclusions: Muscle invasion was associated with higher pathologic tumor staging, poor pathologic factors, and higher rates of positive margin on main specimen.

Keywords: human papilloma virus; muscle invasion; oropharyngeal cancer; transoral robotic surgery.

MeSH terms

  • Carcinoma, Squamous Cell* / pathology
  • Carcinoma, Squamous Cell* / surgery
  • Head and Neck Neoplasms*
  • Humans
  • Muscles / pathology
  • Neoplasm Staging
  • Oropharyngeal Neoplasms* / pathology
  • Oropharyngeal Neoplasms* / surgery
  • Retrospective Studies
  • Robotic Surgical Procedures*