title: Oncologic, functional and surgical outcomes of primary Transoral Robotic Surgery for early squamous cell cancer of the oropharynx: a systematic review.
abstract: OBJECTIVE
  Transoral Robotic Surgery (TORS) has emerged as an alternative to radiotherapy or chemoradiotherapy for the treatment of oropharyngeal squamous cell carcinoma (OPSCC). Many centers restrict the use of TORS to early (T1-2) OPSCC. The purpose of this article was to assess oncologic and functional outcomes of TORS for primary treatment of early OPSCC.
  
  
  METHODS
  Systematic review.
  
  
  METHODS
  A systematic literature search was performed for all relevant English language studies using Embase, Medline, and Pubmed. Our primary outcome measure was local control; secondary outcomes included overall survival (OS) and tracheostomy tube (TT) and gastrostomy tube (GT) dependence rates. Three authors independently extracted study information and analyzed all included articles for quality and bias using the Newcastle-Ottawa Quality Assessment Scale.
  
  
  RESULTS
  A total of 206 papers were identified, with 11 meeting the inclusion criteria (190 patients). For T1-2 OPSCC, the aggregate local control rate was 96.3% with an OS rate of 95.0%. Rates of prolonged (>12 month) TT and GT dependence were 0.0% and 5.0% respectively.
  
  
  CONCLUSIONS
  This systematic review suggests that TORS offers high rates of disease control with low rates of long-term TT or GT dependence in T1-2 OPSCC. However, further study is needed to compare TORS outcomes to those of traditional therapies.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, University of Ottawa, Ottawa, Canada.
authors.forename: Kate
authors.initials: K
authors.lastname: Kelly
authors.affiliation: FRCSC, Department of Otolaryngology-Head & Neck Surgery, University of Ottawa, Ottawa, Canada. Electronic address: sjohnsonobaseki@gmail.com.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Johnson-Obaseki
authors.affiliation: University of Ottawa, Ottawa, Canada.
authors.forename: Julie
authors.initials: J
authors.lastname: Lumingu
authors.affiliation: FRCSC, Department of Neurosciences/Otolaryngology-Head and Neck Surgery, Aurora St. Luke's Hospital, Milwaukee, WI, United States.
authors.forename: Martin
authors.initials: M
authors.lastname: Corsten
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D009959:Oropharyngeal Neoplasms / Q000503:physiopathology / Q000601:surgery*; D012371:Robotics; D013514:Surgical Procedures, Operative
keywords: Cancer; Oropharynx; Outcomes; Robot; Squamous cell cancer; Survival; Systematic review; TORS; Transoral Robotic Surgery