title: Transoral robotic surgery and human papillomavirus status: Oncologic results.
abstract: BACKGROUND
  Patients with oropharyngeal squamous cell carcinoma (OPSCC) have been shown to have distinct outcome profiles based on their human papillomavirus (HPV) status. The purpose of this study was to assess HPV-related outcomes after transoral robotic surgery (TORS) with adjuvant therapy as indicated.
  
  
  METHODS
  This study consisted of a retrospective review of 50 patients with OPSCC within a prospective single-arm cohort study. Outcome measures included HPV status, margin status, relapse pattern, and survival.
  
  
  RESULTS
  Thirty-seven patients were HPV-positive (74.0%) with 34 patients (91.9%) being serotype-16. Negative margins were achieved in 92.3% (HPV-negative) and 94.6% (HPV-positive). In the HPV-negative group, there were no local recurrences and 1 patient had both regional and distant recurrence (7.7%). In the HPV-positive group, there were no local or regional recurrences and 2 patients (5.4%) had distant recurrences. There were no statistically significant differences in survival between the 2 cohorts (overall survival, disease-specific survival, disease-free survival).
  
  
  CONCLUSIONS
  TORS as a primary surgical modality, followed by adjuvant therapy as indicated, offers disease control in both HPV-negative and HPV-positive groups. We believe that multi-institutional studies are warranted to further evaluate this novel approach for patients who are HPV negative and HPV positive.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania, USA.
authors.forename: Marc A
authors.initials: MA
authors.lastname: Cohen
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Weinstein
authors.forename: Bert W
authors.initials: BW
authors.lastname: O'Malley
authors.forename: Michael
authors.initials: M
authors.lastname: Feldman
authors.forename: Harry
authors.initials: H
authors.lastname: Quon
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000601:surgery* / Q000821:virology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000401:mortality / Q000601:surgery* / Q000821:virology; D013517:Otorhinolaryngologic Surgical Procedures; D027383:Papillomaviridae / Q000145:classification / Q000302:isolation & purification*; D011379:Prognosis; D012371:Robotics; D015996:Survival Rate