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Updated: Nov 2, 2025
Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
Published on: September 15, 2023
Oncologic outcomes of transoral robotic surgery for HPV-negative oropharyngeal carcinomas
Harman S Parhar1, Gregory S Weinstein1, Bert W O'Malley1
1Department of Otorhinolaryngology - Head & Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Background:
Patients with human papillomavirus (HPV)-negative oropharyngeal squamous cell carcinoma (OPSCC) continue to experience disappointing outcomes following chemoradiotherapy (CRT) and appreciable morbidity following historical surgical approaches. We aimed to investigate the oncologic outcomes and perioperative morbidity of a transoral robotic surgery (TORS) approach to surgically resectable HPV-negative OPSCC.
Methods:
Retrospective analysis HPV-negative OPSCC patients who underwent TORS, neck dissection and pathology-guided adjuvant therapy (2005-2017).
Results:
Fifty-six patients (91.1% stage III/IV) were included. Three-year overall survival, locoregional control, and disease-free survival were 85.5%, 84.4%, and 73.6%, respectively (median follow-up 30.6 months, interquartile range 18.4-66.6). Eighteen (32.1%) patients underwent adjuvant radiotherapy and 20 (39.3%) underwent adjuvant CRT. Perioperative mortality occurred in one (1.8%) patient and hemorrhage occurred in two (3.6%) patients. Long-term gastrostomy and tracheostomy rates were 5.4% and 0.0%, respectively.
Conclusion:
The TORS approach for resectable HPV-negative OPSCC can achieve encouraging oncologic outcomes with infrequent morbidity.
Insights
Transoral robotic surgery (TORS) shows promising results for human papillomavirus (HPV)-negative oropharyngeal squamous cell carcinoma (OPSCC). This approach offers encouraging oncologic outcomes with manageable side effects for resectable cases.
Area of Science:
- Surgical Oncology
- Head and Neck Cancer Research
- Robotic Surgery Innovations
Background:
- Human papillomavirus (HPV)-negative oropharyngeal squamous cell carcinoma (OPSCC) presents treatment challenges.
- Current treatments like chemoradiotherapy (CRT) and traditional surgery have limitations in outcomes and morbidity.
Purpose of the Study:
- To evaluate the oncologic outcomes of transoral robotic surgery (TORS) for surgically resectable HPV-negative OPSCC.
- To assess the perioperative morbidity associated with the TORS approach in this patient cohort.
Main Methods:
- Retrospective analysis of HPV-negative OPSCC patients treated with TORS, neck dissection, and adjuvant therapy.
- Data collected from 2005 to 2017, including survival rates and complication data.
Main Results:
- High survival rates: 3-year overall survival (85.5%), locoregional control (84.4%), and disease-free survival (73.6%).
- Low perioperative morbidity: 1.8% mortality, 3.6% hemorrhage, and low long-term gastrostomy (5.4%) or tracheostomy (0.0%) rates.
- Adjuvant therapy utilized in a significant portion: 32.1% received radiotherapy, 39.3% received CRT.
Conclusions:
- Transoral robotic surgery (TORS) is a viable option for resectable HPV-negative OPSCC.
- The TORS approach demonstrates favorable oncologic control and acceptable perioperative morbidity.
