[Cox model analysis of curative effect and prognostic factors of oral robot-assisted RPLN dissection for head and neck malignancies].

Purpose: To investigate the efficacy and prognostic factors of oral robot-assisted retropharyngeal lymph node (RPLN) dissection in the treatment of head and neck malignancies.

Methods: Sixty-eight patients with head and neck malignant tumors who were treated in our hospital from January 2017 to December 2019 and followed up until December 2022 were treated by oral robot-assisted RPLN dissection. The clinical remission rate, clinical control rate, operation time, intraoperative blood loss, length of hospital stay, and the survival rate and survival time at 1, 2 and 3 years of follow-up were compared. SPSS 22.0 software package was used for statistical analysis of the data.

Results: All 68 patients with head and neck tumors were successfully treated by oral robot-assisted RPLN resection, and no complications such as postpharyngeal incision massive bleeding, Horner syndrome, aspiration pneumonia were found in all patients. The follow-up was 3 years, the survival time was(31.15±4.93) months, the survival rate was 91.18%(62/68) at the first year, 85.29%(58/68) at the second year and 70.59% (48/68) at the third year. There was no significant difference in 3-year survival rate among different genders, ages, disease types, primary lesions, exocapsular lymph node invasion and peripheral nerve invasion (P＞0.05). There were significant differences in the 3-year survival rate of different T stages, N stages, TNM stages, maximum diameter of invaded lymph nodes and vascular cancer thrombus(P＜0.05). Cox proportional risk regression model analysis showed that stage T3 to 4, stage N2b to 3, stage Ⅳb TNM, maximum diameter of invaded lymph node ＞6 cm and vascular cancer thrombi were independent risk factors affecting the 3-year survival rate of head and neck cancer patients after surgery(P＜0.05).

Conclusions: Oral robotic assisted RPLN dissection has certain efficacy in the treatment of head and neck malignant tumors, but the survival rate of patients is affected by T stage, N stage, TNM stage, maximum diameter of invaded lymph nodes, vascular cancer thrombolus and other factors, which should be paid more attention in clinic.