The RECUT Study
Research type
Research Study
Full title
The RECUT Study - transoral Robotic surgery for rECurrent tumours of the Upper aerodigestive Tract
IRAS ID
268830
Contact name
Vinidh Paleri
Contact email
Sponsor organisation
Royal Marsden NHS Foundation Trust
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Summary of Research
Recurrent head and neck (H&N) cancer is being increasingly been managed by surgical resection with good outcomes. The emerging role of transoral robotic surgery (TORS) has not been fully assessed in this context. This study will review anonymised records of patients undergoing TORS for recurrent H&N cancer at a number of international institutions. The primary outcome measure will be disease free survival at 2 years, with secondary outcomes of tracheostomy usage and gastrostomy usage also considered, to report functional outcomes from the surgeries.
Summary of Results
An international study was conducted of patients undergoing transoral robotic surgery (TORS) for residual or recurrent cancer in the head and neck. TORS is a minimally invasive surgical technique which uses robotic technology to treat some head and neck cancers. Following TORS, in a selected patient population, nearly three quarters (72%) of patients treated with TORS were still alive. This improves on other treatments currently available to this patient group, which often includes further radiotherapy or open surgery, in combination or alone, or chemotherapy with palliative intent.
RECUT analysed the data of 278 of consecutive cases from 16 centres across the UK, Europe, North America, and India. All patients had previously been treated for a head or neck cancer with radiotherapy and were subsequently diagnosed with recurrent mouth or throat cancer and were treated with TORS prior to 1 August 2018.
Previous studies have reported two-year survival rates for patients with recurrent head and neck cancer following repeat treatment with intensity-modulated radiotherapy (IMRT), which uses linear accelerators to deliver very precise doses of radiation shaped to the size of the tumour, is around four to five in 10 (40-50%), while repeated IMRT and open surgery is just over three fifths (62%). Two-year survivals rates for patients treated with open surgery alone have been reported as around one in two (52%).
RECUT also suggests that TORS can offers patients’ good quality of life compared with other treatment options. It revealed that, immediately following TORS, around two fifths of patients were supported with a tracheostomy (38%) for breathing and/or a gastrostomy (39%) for eating. After a year, this had fallen to just one in ten (11%) with tracheostomies and a third (34%) with gastronomies but, crucially, nearly three quarters (74%) of patients were able to eat soft foods or better.
This is an improvement compared with open surgery offered for the same condition, with previous studies reporting that, following open surgery, around four fifths (79%) of patients with recurrent head and neck cancer need a tracheostomy and three-quarters (75%) need a gastrostomy.REC name
East of England - Cambridge Central Research Ethics Committee
REC reference
19/EE/0307
Date of REC Opinion
18 Oct 2019
REC opinion
Favourable Opinion