Head and neck cancers account for 3 to 5 percent of all cancer in the United States, according to the American Society of Clinical Oncology, which means proving the efficacy of a robotic detection technique could have a big impact on public health.
A University of Pittsburgh study shows using robotics to identify neck tumors can improve individualized treatment and increase survival rates.
The three-year study, led by Dr. Umamaheswar Duvvuri, an assistant professor of Otolaryngology, shows the use of trans-oral robotic surgery (TORS) more accurately identifies the cause of unknown swellings in the neck. TORS uses robotic cameras and other tools to reach into the oral cavity without making incisions needed to allow access by human hands and eyes.
The study looked at 206 head and neck robotic procedures performed at UPMC from 2009 through 2012. TORS were used on 22 patients with unidentified neck lumps. Of those 22 patients, the primary tumors were found in 19 cases.
Duvvuri, a head, neck and endocrine oncologic surgeon at UPMC, said TORS have a 90 percent success rate in finding primary tumors compared to past treatments.
“We were not able to do these types of procedures before easily,” he said. “Because the tissues on the back of the tongue are hard to reach. It’s not a straight shot. Having the robotics system allows us to get back to the back of the tongue and allows us to see these areas better and affect them.”
Traditionally, doctors rely on endoscopies and scans to find tumors, but those methods only come with a 30 percent success rate.
The study shows patients who have their primary tumors identified at the initial surgical evaluation typically live at least a year longer than those who don’t.
Duvvuri said cases of head and neck cancers, like the human papillomavirus, are steadily increasing.
“It’s becoming a much more prevalent disease,” he said. “We’re seeing more and more of these patients and just at the University of Pittsburgh we have seen almost a quintupling of the incidents of these patients in the last two decades.”
Duvvuri is currently working on a clinical trial to test the uses of TORS in treatments and outcomes.
“What we’ve done so far is a retrospective study, which is a good starting point, but a prospective clinical trial is really the gold standard,” he said.
The American Society of Clinical Oncology estimates 53,640 people will develop head and neck cancers this year, while 11,520 people are expected to die from the disease.