Oncological and functional outcomes for transoral robotic surgery versus radiotherapy in T1-2 N0-1 p16+ oropharyngeal carcinoma

Abstract

Objectives: Oncological and functional outcomes for T1-2 N0-1 (TNMv8) p16-positive oropharyngeal squamous cell carcinoma patients were analysed according to treatment: either transoral robotic surgery (TORS) (Surgery group - TORS and neck dissection ± adjuvant radiotherapy/chemoradiotherapy) or primary radiotherapy/chemoradiotherapy (Oncology group).

Methods: Single-centre retrospective observational study.

Results: The two-year disease-free survival rate was 88 per cent for the Oncology group (n = 42) and 95 per cent for the Surgery group (n = 44). The two-year overall survival rate was 98 per cent for the Oncology group and 100 per cent for the Surgery group. The functional swallowing outcome at two years post-treatment was similar in both groups. Subgroup analysis showed patients treated with surgery-only with no adjuvant treatment had the best functional outcome whilst patients treated with surgery and post-operative chemoradiotherapy had the worst functional outcome.

Conclusion: The overall oncological and functional outcomes at two years were similar in both groups. Patients treated with surgery-only had the best functional outcome without compromised oncological outcome.

Keywords: head and neck cancer; head and neck surgery; oncology; oropharynx; swallowing.