Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2021 Sep;46(5):1005-1012.
doi: 10.1111/coa.13769. Epub 2021 May 31.

Primary transoral robotic surgery +/- adjuvant therapy for oropharyngeal squamous cell carcinoma-A large observational single-centre series from the United Kingdom

James O'Hara  1   2 , Laura Warner  1 , Hannah Fox  1 , David Hamilton  1   2 , David Meikle  1 , Paul Counter  3 , Andrew Robson  3 , Rebecca Goranova  4 , Shahid Iqbal  5 , Charles Kelly  5 , Max Robinson  6 , Vinidh Paleri  7
Affiliations
Observational Study

Primary transoral robotic surgery +/- adjuvant therapy for oropharyngeal squamous cell carcinoma-A large observational single-centre series from the United Kingdom

James O'Hara et al. Clin Otolaryngol. 2021 Sep.

Abstract

Objectives: To analyse the oncological outcomes following primary Transoral Robotic Surgery (TORS) for oropharyngeal squamous cell carcinoma (OPSCC).

Design: Observational case series.

Setting: Tertiary centre; first TORS practice to commence in the UK.

Participants: All consecutive patients undergoing primary TORS with curative intent, with or without adjuvant treatment.

Main outcome measures: Descriptive analysis of patient and tumour pathology variables. Survival outcomes: Overall, Disease-Specific, Progression-Free and Locoregional control.

Results: The cohort comprised of 120 patients undergoing TORS with minimum 12-month follow-up data and the following characteristics: mean age 58 years, 91 males (76%), 78 tonsil (65%) and 34 base of tongue primaries (28%), 89% HPV-related OPSCC. The surgical pathology revealed 14 (12%) with positive margins, 19 (16%) had close margins <2mm and 31% with extranodal extension. The treatment was as follows: 39 (33%) treated with TORS alone, 50 (42%) received adjuvant radiotherapy and 31 (26%) received adjuvant radiotherapy with chemotherapy. There were 15 recurrences. Estimated survival for all patients at 3 years (95% CI): overall 85% (78-92), disease-specific 90% (85-96), progression-free 86% (79-92) and locoregional control 90% (84-96). The equivalent survival figures for the HPV-related cases alone were as follows: overall 88% (82-94), disease-specific 93% (87-98), progression-free 88% (81-95) and locoregional control 92% (87-98).

Conclusions: Whilst TORS has become a common practice in the management of OPSCC in the UK, these are the first reported oncological outcomes. For selected patients, TORS with or without adjuvant therapy is an appropriate treatment modality.

Keywords: Transoral Robotic Surgery; chemotherapy; human papilloma virus; oropharyngeal carcinoma; radiotherapy.

PubMed Disclaimer

References

REFERENCE

    1. Schache AG, Powell NG, Cuschieri KS, et al. HPV-related oropharynx cancer in the United Kingdom: an evolution in the understanding of disease etiology. Can Res. 2016;76(22):6598-6606.
    1. Centre THaSCI. National Head and Neck Cancer Audit 2014. UK.
    1. de Almeida JR, Byrd JK, Wu R, et al. A systematic review of transoral robotic surgery and radiotherapy for early oropharynx cancer: a systematic review. Laryngoscope. 2014;124(9):2096-2102.
    1. Fox HR, Robson A, Cocks H, et al. Contralateral neck metastases in lateralised, resectable advanced stage oropharyngeal squamous cell carcinoma-Results of 57 patients undergoing bilateral selective neck dissection. Clin Otolaryngol. 2018;43(2):739-741.
    1. O'Hara J, Cosway B, Muirhead C, Leonard N, Goff D, Patterson J. Transoral laser microsurgery +/- adjuvant therapy versus chemoradiotherapy for stage III and IVA oropharyngeal squamous cell carcinoma: Preliminary comparison of early swallowing outcomes. Head Neck. 2015;37(10):1488-1494.

Publication types

LinkOut - more resources