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), locoregional control 90% (84‐96). The equivalent survival figures for the HPV‐related cases alone were: overall 88% (82‐94), disease‐specific 93% (87‐98), progression‐free 88% (81‐95), 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.
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