Oncologic outcomes and patient-reported quality of life in patients with oropharyngeal squamous cell carcinoma treated with definitive transoral robotic surgery versus definitive chemoradiation.
It has been postulated that treatment outcomes are similar between transoral robotic surgery (TORS) and definitive chemoradiation (CRT) for oropharyngeal squamous cell carcinomas (OPSCC). We compared oncologic and quality of life (QOL) outcomes between definitive CRT and definitive TORS.



An observational comparison study was performed on 92 patients treated with TORS±adjuvant therapy and 46 patients treated with definitive CRT between July 2005 and January 2016. The Kaplan Meier method was used for survival analyses, and the Mann-Whitney test was used to compare QOL scores between groups.



All patients had T0-T2 and N0-N2 disease, although CRT patients had higher clinical staging (p<0.001). HPV+ disease was present in 79% (n=73) of TORS patients and 91% (n=19) of tested CRT patients. Median follow-up was 22.1months (range: 0.33-83.4). There were no significant differences in locoregional control or overall survival between CRT and TORS groups. Definitive TORS resulted in better saliva-related QOL than definitive CRT at 1, 6, 12, and 24months (p<0.001, p=0.025, p=0.017, p=0.011). Among TORS patients, adjuvant therapy was associated with worse QOL in the saliva domain at 6, 12, and 24months (p<0.001, p<0.001, p=0.007), and taste domain at 6 and 12months (p=0.067, p=0.008).



Definitive CRT and definitive TORS offer similar rates of locoregional control, overall survival, and disease-free survival in patients with early stage OPSCC. TORS resulted in significantly better short and long-term saliva-related QOL, whereas adjuvant therapy was associated with worse saliva and taste-related QOL compared to TORS alone.
Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA, United States.
D C
DC
Ling
Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA, United States.
B V
BV
Chapman
Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
J
J
Kim
Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
G W
GW
Choby
Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA, United States.
P
P
Kabolizadeh
Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA, United States.
D A
DA
Clump
Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
R L
RL
Ferris
Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
S
S
Kim
Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA, United States.
S
S
Beriwal
Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA, United States; Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
D E
DE
Heron
Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States. Electronic address: duvvuriu@upmc.edu.
U
U
Duvvuri
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D011788:Quality of Life; D065287:Robotic Surgical Procedures; D016896:Treatment Outcome
Chemoradiotherapy; Head and neck cancer; Oropharyngeal cancer; Quality of life; Robotic surgical procedures; Squamous cell carcinoma; Treatment outcome
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