Related Experiment Video
Updated: Nov 11, 2025
Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
Published on: September 15, 2023
Outcomes of HPV-Negative Oropharyngeal Cancer Treated With Transoral Robotic Surgery
Ryan S Jackson1, Katelyn Stepan1, Craig Bollig1
1Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri, USA.
Objective:
The incidence of oropharyngeal squamous cell carcinoma (OPSCC) is increasing secondary to human papillomavirus (HPV)-related disease. Despite this, outcomes of patients with HPV-negative OPSCC undergoing transoral robotic surgery (TORS) are largely unknown.
Study Design:
Analysis of the National Cancer Database (NCDB).
Setting:
Not applicable.
Methods:
The 2015 participant user file from the NCDB was analyzed between 2010 and 2015 for patients with OPSCC who underwent TORS and neck dissection. Kaplan-Meier survival analysis was used to estimate overall survival of the study population. Univariable Cox survival analyses was used to determine significant associations between demographic, tumor, and treatment characteristics and overall survival (OS).
Results:
There were 164 patients (124 male and 40 female) with a mean age of 58 years (30-89 years). Median follow-up was 34 months. Five-year OS was 78% (95% CI, 70%-86%). Patients with early stage disease (pT1-2, N0-1) had significantly improved OS compared to patients with advanced T- or N-stage disease (log-rank 0.011; 5-year OS: 88% [95% CI, 78%-98%] vs 66% [95% CI, 50%-82%]).
Conclusion:
Very few patients in the NCDB underwent TORS for HPV-negative OPSCC, but those who did had favorable outcomes, especially in early stage disease. Based on these findings, TORS may be considered in the treatment algorithm for patients with HPV-negative OPSCC.
Level Of Evidence:
Level IV.
Insights
Transoral robotic surgery (TORS) shows favorable outcomes for human papillomavirus (HPV)-negative oropharyngeal squamous cell carcinoma (OPSCC), particularly in early stages. This suggests TORS could be a viable treatment option for these patients.
Area of Science:
- Oncology
- Otolaryngology
- Surgical Oncology
Background:
- Rising incidence of oropharyngeal squamous cell carcinoma (OPSCC) linked to human papillomavirus (HPV).
- Limited data on outcomes for HPV-negative OPSCC patients treated with transoral robotic surgery (TORS).
Purpose of the Study:
- To evaluate the outcomes of HPV-negative OPSCC patients undergoing TORS.
- To determine the survival rates and prognostic factors for this patient group.
Main Methods:
- Analysis of the National Cancer Database (NCDB) from 2010-2015.
- Inclusion of 164 patients with OPSCC who underwent TORS and neck dissection.
- Kaplan-Meier and univariable Cox survival analyses for overall survival (OS).
Main Results:
- Five-year OS was 78% for patients with HPV-negative OPSCC treated with TORS.
- Early-stage disease (pT1-2, N0-1) showed significantly improved OS compared to advanced stages.
- Median follow-up was 34 months with favorable survival rates observed.
Conclusions:
- Transoral robotic surgery (TORS) demonstrates favorable outcomes for HPV-negative OPSCC, especially in early stages.
- TORS may be a valuable component of the treatment strategy for HPV-negative OPSCC.
- Further research is warranted to confirm these findings in larger cohorts.
