Oncologic Outcomes in Patients with Oropharyngeal Squamous Cell Carcinoma Treated with TORS versus Definitive CRT

Abstract

Objectives: It has been postulated that treatment outcomes are similar between transoral robotic surgery (TORS) and definitive chemoradiation (CRT) for patients with oropharyngeal squamous cell carcinomas (OPSCC). We compared oncologic outcomes between OPSCC patients treated with definitive CRT and those treated with TORS only. Methods: An observational comparison study was performed on 23 patients treated with TORS without adjuvant therapy and 33 patients treated with definitive CRT between July 2005 and December 2013. All patients had early stage disease with T0-T2 and N0-N2. Median age was 57 (range: 36-82) years and 80.4% of patients were male, which was similar between groups. Human papillomavirus (HPV)+ disease was present in 70.0% of TORS and 33.3% of CRT patients, although HPV status was not tested in 63.6% of the CRT patients. Results: Median follow-up was 22.5 months (range, 0.33-83.4 months). Local failure rate for the entire cohort was 7.1% (9.1% for definitive CRT, 4.3% for TORS, P = .85). Overall regional failure rate was 3.6% (3.0% for definitive CRT, 4.3% for TORS, P = .48). Overall distant failure rate was 5.4% (9.1% for definitive CRT, 0.0% for TORS, P = .24). Two-year actuarial disease-free survival (DFS) was 86.7% for definitive CRT patients and 80.0% for patients treated with TORS alone ( P = .69). Conclusions: Definitive CRT and TORS alone offer similar rates of locoregional control, distant control, and DFS in patients with early stage OPSCC. Further studies are needed to assess the effect of CRT and TORS on quality of life in this patient population.