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Background

In patients with swollen lymph nodes in the head and neck area, finding the original tumor site helps doctors target radiotherapy more accurately. This can lead to better treatment outcomes by reducing unnecessary radiation exposure to healthy tissues and lowering side effects. Current methods, including advanced imaging and surgery, can identify the primary cancer in 60% of cases. A procedure called mucosectomy of the tongue base shows promise for finding more tumors. When done using less invasive techniques like robotic or laser surgery, it results in fewer complications. However, we still need to test how effective this method is in a clinical trial.

Methods

The RoboCUP trial is a clinical study designed to evaluate the benefits of a specific surgical approach. It compares two groups of patients: one group will undergo tongue base mucosectomy along with tonsillectomy, while the other group will have only tonsillectomy. The main goal is to see how many patients can have their primary cancer detected. After surgery, all patients will receive targeted radiotherapy, possibly combined with chemotherapy, following standard treatment guidelines. The trial will involve 72 patients, split evenly between the two groups.

Discussion

This trial aims to enhance the ability to detect primary tumors in patients with unknown cancer origins in the head and neck. Improved detection could lead to better treatment accuracy, improved patient outcomes, and a better quality of life.

Trial Registration

The trial is registered under NCT04767048 since February 19, 2021.

Measurable Outcomes

Establish clear goals for the effectiveness of the surgical approach in identifying primary cancers. This will help clinics and patients understand the potential benefits of the RoboCUP trial.