Transoral robotic surgery alone for oropharyngeal cancer: an analysis of local control.
OBJECTIVE
To evaluate local control following transoral robotic surgery (TORS) with the da Vinci Surgical System (Intuitive Surgical Inc) as a single treatment modality for oropharyngeal squamous cell carcinoma (OSCC).


METHODS
Prospective, single-center, observational study.


METHODS
Academic university health system and tertiary referral center.


METHODS
Thirty adults with previously untreated OSCC.


METHODS
Transoral robotic surgery with staged neck dissection as indicated.


METHODS
Local control and margin status.


RESULTS
Thirty patients were enrolled with previously untreated OSCC and no prior head and neck radiation therapy. Follow-up duration was at least 18 months. At the time of diagnosis, 9 tumors were T1 (30%); 16 were T2 (53%); 4 were T3 (13%); and 1 was T4a (3%). The anatomic sites of these primary tumors were tonsil in 14 (47%), tongue base in 9 (30%), glossotonsillar sulcus in 3 (10%), soft palate in 3 (10%), and oropharyngeal wall in 1 (3%). There was only 1 patient (3%) who had a positive margin after primary resection; further resection achieved a final negative margin. Perineural invasion was noted in 3 tumors (10%). No patient received postoperative adjuvant therapy. At a mean follow-up of 2.7 years (range, 1.5-5.1 years), there was 1 patient with local failure (3%).


CONCLUSIONS
As the only modality used for treatment of pathologically low-risk OSCCs, TORS provides high local control and is associated with low surgical morbidity.
Department of Otorhinolaryngology–Head and Neck Surgery, University of Pennsylvania Medical Center, Philadelphia, USA. gregory.weinstein@uphs.upenn.edu
Gregory S
GS
Weinstein
Harry
H
Quon
H Jason
HJ
Newman
J Ara
JA
Chalian
Kelly
K
Malloy
Alexander
A
Lin
Arati
A
Desai
Virginia A
VA
Livolsi
Kathleen T
KT
Montone
K Roger
KR
Cohen
Bert W
BW
O'Malley
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies; D012371:Robotics; D016896:Treatment Outcome