title: Transoral robotic approach to carcinoma of unknown primary.
abstract: BACKGROUND
  The management of carcinoma of unknown primary (CUP) is one of the challenging conditions in head and neck oncologic surgery. Despite various diagnostic tools, the primary tumor site in more than half of cases remains unidentified. The purpose of this study was to assess the feasibility and efficiency of utilizing transoral robotic surgery (TORS) for the diagnosis and treatment of CUP in the head and neck.
  
  
  METHODS
  In this prospective, single-institutional, clinical TORS trial, 22 of 181 patients were treated for CUP between 2008 and 2012.
  
  
  RESULTS
  Among all those 22 patients, primary tumor site identification and complete tumor removal was achieved in 17 patients (77.3%) with TORS. Tonsil (59.1%) and base of tongue (18.1%) were identified as the most common tumor locations.
  
  
  CONCLUSIONS
  Together with panendoscopy, directed biopsies, and positron emission tomography (PET)/CT, TORS is a valuable option in the identification and treatment of primary tumor sites.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Comprehensive Cancer Center, Wexner Medical Center at The Ohio State University, Columbus, Ohio.
authors.forename: Kasim
authors.initials: K
authors.lastname: Durmus
authors.forename: Sanjeet V
authors.initials: SV
authors.lastname: Rangarajan
authors.forename: Matthew O
authors.initials: MO
authors.lastname: Old
authors.forename: Amit
authors.initials: A
authors.lastname: Agrawal
authors.forename: Theodoros N
authors.initials: TN
authors.lastname: Teknos
authors.forename: Enver
authors.initials: E
authors.lastname: Ozer
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000556:secondary / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D037981:Neck Dissection; D009382:Neoplasms, Unknown Primary; D011446:Prospective Studies; D012307:Risk Factors; D065287:Robotic Surgical Procedures / Q000379:methods*; D012907:Smoking / Q000009:adverse effects; D014062:Tongue Neoplasms / Q000175:diagnosis / Q000556:secondary / Q000601:surgery*; D014067:Tonsillar Neoplasms / Q000175:diagnosis / Q000556:secondary / Q000601:surgery*; D016896:Treatment Outcome
keywords: carcinoma of unknown primary; daVinci; transoral robotic surgery