title: Transoral robotic surgery alone for oropharyngeal cancer: quality-of-life outcomes.
abstract: OBJECTIVE
  Few studies have examined quality-of-life (QOL) outcomes in patients who undergo transoral robotic surgery (TORS) alone (ie, without adjuvant radiotherapy or chemoradiotherapy).
  
  
  OBJECTIVE
  To report QOL outcomes of patients with oropharyngeal squamous cell carcinoma who receive only TORS.
  
  
  METHODS
  Medical records for all patients undergoing TORS for treatment of primary oropharyngeal squamous cell carcinoma from May 1, 2010, to March 31, 2014, at a tertiary care academic cancer center were examined from June through September 2014. Thirty-four patients who did not receive adjuvant therapy after TORS were included in the study.
  
  
  METHODS
  Primary surgical resection via TORS.
  
  
  METHODS
  The University of Washington Quality of Life, version 4, questionnaire was completed by patients preoperatively and at 1-, 6-, 12-, and 24-month intervals after TORS. Demographic, clinicopathologic, and follow-up data were collected.
  
  
  RESULTS
  Mean follow-up time was 14 months (May 1, 2010, to April 30, 2014). Most patients had T1 (20 [59%]) or T2 (13 [38%]) and N0 (13 [38%]) or N1 (16 [47%]) disease. Statistically significant improvement in QOL outcomes was noted in the following postoperative domains: chewing from 1 month (median, 50 [IQR, 50-100]) to 12 months (100 [IQR, 100-100]; P = .048), swallowing from 1 month (70 [IQR, 30-85]) to 6 months (100 [IQR, 70-100]; P = .047) and 1 to 24 months (100 [IQR, 70-100]; P = .048), pain from 1 month (38 [IQR, 25-75]) to 6 months (88 [IQR, 75-100]; P = .006) and 1 to 12 months after surgery (100 [IQR, 75-100]; P = .01), and activity from 1 month (63 [IQR, 50-88]) to 24 months (100 [IQR, 75-100]; P = .03). Two participants (6%) died during the follow-up period: 1 because of disease and 1 because of a myocardial infarction. Two patients (6%) required temporary gastrostomy tube placement, but none required tracheostomy.
  
  
  CONCLUSIONS
  Appropriately selected patients who undergo TORS alone for oropharyngeal squamous cell carcinoma experience acceptable short- and long-term QOL outcomes.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center Pittsburgh, Pennsylvania.
authors.forename: Garret W
authors.initials: GW
authors.lastname: Choby
authors.affiliation: medical student, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Jeehong
authors.initials: J
authors.lastname: Kim
authors.affiliation: medical student, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Diane C
authors.initials: DC
authors.lastname: Ling
authors.affiliation: Biostatistics Facility, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania.
authors.forename: Shira
authors.initials: S
authors.lastname: Abberbock
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center Pittsburgh, Pennsylvania.
authors.forename: Rajarsi
authors.initials: R
authors.lastname: Mandal
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center Pittsburgh, Pennsylvania.
authors.forename: Seungwon
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center Pittsburgh, Pennsylvania.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Ferris
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center Pittsburgh, Pennsylvania4Department of Otolaryngology, Veterans Affairs Pittsburgh Health System, Pittsburgh, Pennsylvania.
authors.forename: Umamaheswar
authors.initials: U
authors.lastname: Duvvuri
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000523:psychology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods* / Q000523:psychology; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000523:psychology* / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D012189:Retrospective Studies; D012371:Robotics; D011795:Surveys and Questionnaires; D015996:Survival Rate; D016896:Treatment Outcome