Is There a Role for Robotic Surgery in the Treatment of Head and Neck Cancer?
Given the potential for long-term toxicities from concurrent chemoradiation, there is great interest in surgery as a primary treatment modality for head and neck cancers, particularly in the younger HPV-positive oropharyngeal cancer patient. Transoral robotic surgery (TORS) has proven to be an effective technique to safely treat oropharyngeal and select supraglottic tumors surgically. Sound, traditional surgical principles are employed using improved endoscopic visualization and precise instrumentation to perform oncologic surgery without the morbidity of transmandibular or transcervical approaches. Although level 1 evidence prospective clinical trials are currently underway for TORS, the literature supports its safety and efficacy based on numerous studies. Currently, prospective randomized trials are underway to provide better evidence for or against TORS in oropharyngeal cancer. Patient selection based on comorbidities, anatomy, and available pathological data is critical in choosing patients for TORS.
Department of Otolaryngology, Medical College of Georgia at Augusta University, 1120 15th Street, BP 4109, Augusta, GA, 30912, USA.
J Kenneth
JK
Byrd
Department of Otolaryngology, University of Pittsburgh Medical Center, 200 Lothrop Street, EEI 500, Pittsburgh, PA, 15213, USA. ferrrl@upmc.edu.
Robert L
RL
Ferris
D002986:Clinical Trials as Topic; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000473:pathology / Q000601:surgery; D065287:Robotic Surgical Procedures / Q000379:methods; D016896:Treatment Outcome
Head and neck cancer; Minimally invasive surgery; Oropharyngeal cancer; TORS; Transoral robotic surgery