Investigating the Impact of Transoral Robotic Surgery (TORS) on Nutrition and Swallowing Outcomes

Patients with head and neck cancer (HNC) have a high risk of malnutrition, sarcopenia and dysphagia. Existing nutrition guidelines are available for the management of patients undergoing radiotherapy/chemotherapy, however there is a lack of specific guidelines for patients undergoing surgical resection. Trans Oral Robotic Surgery (TORS) is a relatively new surgical technique that is increasingly being used for early-stage oropharyngeal cancer with positive clinical and functional outcomes, but little is known about nutrition and swallowing outcomes. As the prevalence of oropharyngeal cancer is increasing (due to infection with the human-papilloma virus), it is anticipated that this surgical technique will become increasingly more utilised in the future. The limited knowledge of these surgical procedures on nutrition and swallowing outcomes therefore provides a unique opportunity for novel research in this field. The aim of this study is to investigate the impact of TORS in relation to nutrition and swallowing outcomes, with the objectives being to: i) determine the prevalence of pre-operative sarcopenia, dysphagia and malnutrition, ii) determine the post-operative nutrition, swallowing and clinical outcomes and associated quality of life iii) understand patient experience and satisfaction with healthcare management associated with the TORS and to identify any unmet nutrition and swallowing care needs from a patient perspective. This is a prospective longitudinal cohort study of all patients undergoing TORS from July 2023 to June 2024 who will be followed up for 12 months post op. The findings from this research project will improve knowledge of the nutritional and swallowing needs of patients undergoing surgical resection with the view to translate these findings into comprehensive nutrition and swallowing management guidelines.