Survival following TORS for Oropharyngeal SCC

Abstract

Objective: Report patient characteristics and oncologic results of transoral robotic surgery (TORS) for oropharyngeal squamous cell carcinoma (OPSCC). Method: Retrospective review of 52 patients who underwent TORS with neck dissection and postoperative adjuvant treatment as indicated for OPSCC within a prospective single-arm cohort study at an academic medical center. Tumor stage, human papillomavirus (HPV) status, pathology (margin status, nodal status, extracapsular spread), and survival data were collected. Results: Forty-two patients had HPV testing with 36 patients being HPV positive (85.7%). Most patients presented with advanced stage disease: 40 patients (76.9%) stage IV and 6 patients (11.5%) stage III. Mean length of follow-up was 21 months. Overall survival at 1 and 2 years was 97.9% and 72.7%, respectively, and disease-specific survival at 1 and 2 years was 100% and 84.2%, respectively. There were 2 local recurrences (3.8%), 3 regional recurrences (5.8%), and 2 distant recurrences (3.8%). Subset survival analysis based on HPV status is presented along with predictors of survival in multivariate analysis. Conclusion: Oncologic outcomes are promising for patients with advanced OPSCC treated with TORS and postoperative adjuvant therapy as indicated. Further prospective study stratified by HPV status is needed to determine the role of TORS in the management of these patients.