TORS for head and neck squamous cell carcinoma (HNSCC): the Hamburg experience

To report 2.5-year survival outcomes for head and neck squamous cell carcinoma treated primarily with transoral robotic-assisted resection.

Fifty consecutive, appropriately staged patients were enrolled prospectively, and underwent transoral robotic surgery between September 2011 and August 2013. There were 18 patients with overall Stage I-II and 32 patients with Stage III-IV disease. Adjuvant treatment could be spared for 20 patients. Another 5 patients refused the recommended adjuvant treatment. Seventeen patients received 60 Gy adjuvant radiotherapy and 8 patients underwent 66 Gy adjuvant chemo-radiotherapy.

Overall survival was 94% with two disease-specific deaths and one unrelated death. The 2.5-year disease free survival rate was 88%, and the 2.5-year recurrence-free survival was 80%. Local recurrence rate was 10% after 2.5 years.

Using TORS as their primary modality, 40% of the patients did not need adjuvant treatment and showed similar survival rates to that of conventional surgery or primary chemoradiotherapy. In another 34% of the patients, adjuvant chemotherapy could be spared and adjuvant radiotherapy could be reduced by 10 Gy, compared to primary chemoradiotherapy of 70 Gy. This invited report is based on previously published data by the same authors.