Days alive and out of hospital following transoral robotic surgery: Cohort study of 262 patients with head and neck cancer

Background: Days alive and out of hospital (DAOH) is a validated outcome in clinical trials, since it reflects procedure-associated morbidity and mortality. Transoral robotic surgery (TORS) has become a widely adopted procedure with increasing demand for knowledge and data on morbidity. Methods: Retrospective single-center assessment of a prospective TORS database comprising patients treated for malignancy between 2013 and 2018 using DAOH to describe procedure- and disease-related morbidity the first 12-postoperative months. Results: For 262 patients, median DAOH₃₆₅ was 357 days (IQR 351–360). Indications for TORS were (i) primary curative resection (61%), (ii) salvage resection (15%), and (iii) diagnostic work-up of cancer of unknown primary in the head and neck (24%). Median DAOH₃₆₅ was 359 days (IQR 351–361 days), 348 days (IQR 233–355), and 357 days (351–361), respectively. Pneumonia had the highest impact in DAOH₃₆₅ reduction. Conclusion: Total median DAOH₃₆₅ after TORS was 357 days. The main cause leading to DAOH₃₆₅ reduction was pneumonia.