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Cirugía mínimamente invasiva versus radioterapia/quimiorradioterapia para el carcinoma orofaríngeo primario de volumen pequeño

Appendices

Appendix 1. Search strategies

CENTRAL

PubMed

EMBASE (Ovid)

#1 MeSH descriptor: [Oropharyngeal Neoplasms] explode all trees

#2 MeSH descriptor: [Head and Neck Neoplasms] this term only

#3 MeSH descriptor: [Otorhinolaryngologic Neoplasms] explode all trees

#4 MeSH descriptor: [Neoplasms] explode all trees

#5 cancer* or carcinoma* or neoplas* or tumour* or tumour* or malignan* or SCC*

#6 #4 or #5

#7 MeSH descriptor: [Oropharynx] explode all trees

#8 oropharyn* or mesopharyn* or tonsil* or "head and neck" or "head neck" or "head‐neck" or "head‐and‐neck" or tongue

#9 #7 or #8

#10 #6 and #9

#11 HNSCC or SCCHN or OP‐SCC or OPSCC or OPC or SCCOP

#12 #1 or #2 or #3 or #10 or #11

#13 MeSH descriptor: [Surgical Procedures, Operative] explode all trees 93705

#14 surg* or operat* or microsurg* or resect* or dissect* or microdissect* or excis or microresect*

#15 #13 or #14

#16 #12 and #15

#17 MeSH descriptor: [Head and Neck Neoplasms] this term only and with qualifier(s): [Surgery ‐ SU]

#18 MeSH descriptor: [Otorhinolaryngologic Neoplasms] explode all trees and with qualifier(s): [Surgery ‐ SU]

#19 MeSH descriptor: [Oropharyngeal Neoplasms] explode all trees and with qualifier(s): [Surgery ‐ SU]

#20 #16 or #17 or #18 or #19

#21 (minimal* and invasive) or transoral* or trans‐oral* or "trans oral*" or TORS or TOLS or (minimal* and access) or TLM or ORATOR or TOVANS or "video assist*" or video‐assist* or "computer guid*" or computer‐guid* or laser or robot* or TOL

#22 MeSH descriptor: [Robotics] explode all trees

#23 MeSH descriptor: [Laser Therapy] this term only

#24 MeSH descriptor: [Microsurgery] explode all trees

#25 MeSH descriptor: [Surgical Procedures, Minimally Invasive] this term only 813

#26 MeSH descriptor: [Lasers] explode all trees

#27 #21 or #22 or #23 or #24 or #25 or #26

#28 #20 and #27

#1 "Oropharyngeal Neoplasms"[Mesh]

#2 "Head and Neck Neoplasms"[Mesh:NoExp]

#3 "Otorhinolaryngologic Neoplasms"[Mesh]

#4 "Neoplasms"[Mesh]

#5 (cancer* or carcinoma* or neoplas* or tumour* or tumour* or malignan* or SCC*[Title/Abstract])

#6 (#4 OR #5)

#7 "Oropharynx"[Mesh]

#8 (oropharyn* or mesopharyn* or tonsil* or "head and neck" or "head neck" or "head‐neck" or "head‐and‐neck" or tongue[Title/Abstract])

#9 (#7 OR #8)

#10 (#6 AND #9)

#11 (HNSCC or SCCHN or OP‐SCC or OPSCC or OPC or SCCOP)

#12 (#1 OR #2 OR #3 OR #10 OR #11)

#13 "Surgical Procedures, Operative"[Mesh]

#14 (surg* or operat* or microsurg* or resect* or dissect* or microdissect* or excis or microresect*[Title/Abstract])

#15 (#13 OR #14)

#16 (#12 AND #15)

#17 "Head and Neck Neoplasms/surgery"[Mesh:NoExp])

#18 "Otorhinolaryngologic Neoplasms/surgery"[Mesh]

#19 "Oropharyngeal Neoplasms/surgery"[Mesh]

#20 (#16 OR #17 OR #18 OR #19)

#21 (((transoral* or trans‐oral* or "trans oral*" or TORS or TOLS or TLM or ORATOR or TOVANS or "video assist*" or video‐assist* or "computer guid*" or computer‐guid* or laser or robot* or TOL[Title/Abstract])) OR (minimal* and invasive[Title/Abstract])) OR (minimal* and access[Title/Abstract])

#22 "Robotics"[Mesh]

#23 "Laser Therapy"[Mesh:NoExp]

#24 "Microsurgery"[Mesh]

#25 "Surgical Procedures, Minimally Invasive"[Mesh:NoExp]

#26 "Lasers"[Mesh]

#27 (#21 OR #22 OR #23 OR #24 OR #26)

#28 (#20 AND #27)

1 exp oropharynx tumour/

2 "head and neck tumour"/

3 "head and neck cancer"/ or neck tumour/ or nose tumour/ or paranasal sinus tumour/

4 exp neoplasm/

5 (cancer* or carcinoma* or neoplas* or tumour* or tumour* or malignan* or SCC*).tw.

6 4 or 5

7 exp oropharynx/

8 (oropharyn* or mesopharyn* or tonsil* or "head and neck" or "head neck" or "head‐neck" or "head‐and‐neck" or tongue).tw.

9 7 or 8

10 6 and 9

11 (HNSCC or SCCHN or OP‐SCC or OPSCC or OPC or SCCOP).tw.

12 1 or 2 or 3 or 10 or 11

13 exp surgery/

14 (surg* or operat* or microsurg* or resect* or dissect* or microdissect* or excis or microresect*).tw.

15 13 or 14

16 exp oropharynx tumour/su [Surgery]

17 "head and neck tumour"/su [Surgery]

18 12 and 15

19 16 or 17 or 18

20 ((minimal* and invasive) or transoral* or trans‐oral* or "trans oral*" or TORS or TOLS or (minimal* and access) or TLM or ORATOR or TOVANS or "video assist*" or video‐assist* or "computer guid*" or computer‐guid* or laser or robot* or TOL).tw.

21 exp robotics/

22 exp robotics/

23 exp microsurgery/

24 minimally invasive surgery/

25 exp laser/

26 20 or 21 or 22 or 23 or 24 or 25

27 19 and 26

CINAHL (EBSCO)

Web of Science (Web of Knowledge)

Trial registries

S26 S18 AND S25

S25 S19 OR S20 OR S21 OR S22 OR S23 OR S24

S24 (MH "Lasers+")

S23 (MH "Minimally Invasive Procedures")

S22 (MH "Microsurgery+")

S21 (MH "Laser Therapy")

S20 (MH "Robotics")

S19 TX (minimal* and invasive) or transoral* or trans‐oral* or "trans oral*" or TORS or TOLS or (minimal* and access) or TLM or ORATOR or TOVANS or "video assist*" or video‐assist* or "computer guid*" or computer‐guid* or laser or robot* or TOL

S18 S15 OR S16 OR S17

S17 (MH "Otorhinolaryngologic Neoplasms+/SU")

S16 (MH "Head and Neck Neoplasms/SU")

S15 S11 AND S14

S14 S12 OR S13

S13 TX surg* or operat* or microsurg* or resect* or dissect* or microdissect* or excis or microresect*

S12 (MH "Surgery, Operative+")

S11 S1 OR S2 OR S9 OR S10

S10 TX HNSCC or SCCHN or OP‐SCC or OPSCC or OPC or SCCOP

S9 S5 AND S8

S8 S6 OR S7

S7 TX oropharyn* or mesopharyn* or tonsil* or "head and neck" or "head neck" or "head‐neck" or "head‐and‐neck" or tongue

S6 (MH "Oropharynx+")

S5 S3 OR S4

S4 TX cancer* or carcinoma* or neoplas* or tumour* or tumour* or malignan* or SCC*

S3 (MH "Neoplasms+")

S2 (MH "Head and Neck Neoplasms")

S1 (MH "Otorhinolaryngologic Neoplasms+")

#1 TOPIC: (cancer* or carcinoma* or neoplas* or tumour* or tumour* or malignan* or SCC*)

#2 TOPIC: (oropharyn* or mesopharyn* or tonsil* or "head and neck" or "head neck" or "head‐neck" or "head‐and‐neck" or tongue)

#3 #2 AND #1

#4 TOPIC: (HNSCC or SCCHN or OP‐SCC or OPSCC or OPC or SCCOP)

#5 #4 OR #3

#6 TOPIC: (surg* or operat* or microsurg* or resect* or dissect* or microdissect* or excis or microresect*)

#7 TOPIC: ((minimal* and invasive) or transoral* or trans‐oral* or "trans oral*" or TORS or TOLS or (minimal* and access) or TLM or ORATOR or TOVANS or "video assist*" or video‐assist* or "computer guid*" or computer‐guid* or laser or robot* or TOL)

#8 #7 AND #6 AND #5

ICTRP

minimal* AND invasive AND head AND neck OR minimal* AND invasive AND OPSCC OR transoral AND head AND neck OR transoral AND OPSCC OR TORS AND head AND neck OR TORS AND OPSCC OR oropharyn* AND minimal* AND invasive OR oropharyn* AND transoral OR oropharyn* AND TORS

ClinicalTrials.gov

(minimal* AND invasive) OR transoral* OR trans‐oral* OR "trans oral*" OR TORS OR TOLS OR (minimal* AND access) OR TLM OR ORATOR OR TOVANS OR "video assist*" OR video‐assist* OR "computer guid*" OR computer‐guid* OR laser or robot* OR TOL

AND

Condition: head AND neck

Process for sifting search results and selecting studies for inclusion.
Figuras y tablas -
Figure 1

Process for sifting search results and selecting studies for inclusion.

Summary of findings for the main comparison. Minimally invasive surgery versus radiotherapy/chemoradiotherapy for small‐volume primary oropharyngeal carcinoma

Minimally invasive surgery versus radiotherapy/chemoradiotherapy for small‐volume primary oropharyngeal carcinoma

Patient or population: patients with small‐volume primary oropharyngeal carcinoma

Settings: inpatient

Intervention: transoral, minimally invasive surgery (transoral robotic surgery/transoral laser microsurgery) with or without adjuvant radiotherapy or adjuvant chemoradiotherapy

Comparison: primary radiotherapy with or without induction or concurrent chemotherapy

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Primary radiotherapy ± induction or concurrent chemotherapy

Transoral, minimally invasive surgery ± adjuvant radiotherapy or adjuvant chemoradiotherapy

Overall survival

No data

No data

No data

No data

Locoregional control

No data

No data

No data

No data

Progression‐free survival

No data

No data

No data

No data

Gastrostomy rate (at 1 year)

No data

No data

No data

No data

Tracheostomy rate

No data

No data

No data

No data

Swallowing function (MDADI)

No data

No data

No data

No data

Quality of life (EORTC QLQ‐C30 and H&N35)

No data

No data

No data

No data

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; EORTC: European Organisation for Research and Treatment of Cancer; MDADI: MD Anderson Dysphagia Inventory

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

Figuras y tablas -
Summary of findings for the main comparison. Minimally invasive surgery versus radiotherapy/chemoradiotherapy for small‐volume primary oropharyngeal carcinoma