Carta abierta
Hace ya 20 años que se describió la cirugía robótica transoral tal y como la conocemos hoy. El desarrollo experimental fue rápidamente seguido de los correspondientes ensayos clínicos y en el año 2009 la FDA aprobó el uso transoral del sistema de cirugía robótica da Vinci. La evidencia médica se ha acumulado en los últimos años consistentemente a su favor. La cirugía robótica transoral (TORS por sus siglas en inglés) ha permitido expandir la aplicación de los abordajes de mínima invasión en diversos tipos de tumores, y particularmente en el cáncer de orofaringe.
La cirugia robótica transoral es actualmente la estrategia dominante para el tratamiento del cáncer de orofaringe. Para el que no esté familiarizado con este término referido al análisis de coste-efectividad, esto significa que es mejor y menos costosa que sus alternativas. Ha demostrado que mantiene los resultados estándar en control del cáncer, y que obtiene mejores resultados funcionales, con menos morbilidad y menos secuelas. Estos se refiere tanto a sus alternativas por cirugía abierta, como a las alternativas de tratamiento primario no quirúrgico (radioquimioterapia).
El manejo del cáncer de cabeza y cuello en general, y del cáncer de orofaringe en particular, es complejo y debe realizarse en el seno de comités multidisplinares. A cada paciente debe ofrecérsele la mejor de las alternativas de tratamiento de acuerdo con el conocimiento actual de la ciencia médica. Este será normalmente un esquema de tratamiento con una opción primaria quirúrgica o no quirúrgica.
La cirugía abierta de la orofaringe normalmente implica un abordaje transmandibular. El abordaje transmandibular tiene muy pocas indicaciones hoy en día. Si se opta por él deberá explicarse por qué en ese caso particular no puede plantearse una cirugía mínimanente invasiva, con menos morbilidad y menos secuelas para el paciente, ademas de menos costosa.
Las alternativas de tratamiento primario no quirúrgico (radioterapia ó radioquimioterapia) deberán discutirse de acuerdo con la evidencia actual. En Cáncer de Cabeza y Cuello, como normal general, los pacientes con tumores en estadios iniciales (estadios I y II) deberían poderse tratar en monoterapia (cirugía ó radioterapia) y no deberían necesitar tratamiento sistémico (quimioterapia convencional o inmunoterapia).
Prácticamente la totalidad de los pacientes con cáncer de orofaringe relacionado con el virus del papiloma humano (VPH) son estadios I y II. Los pacientes VPH+ representan actualmente en Madrid el 43% de los casos de cancer de orofaringe y este porcentaje está en aumento.
Así que,
- Si eres paciente y tienes un cáncer de orofaringe, tanto si te proponen cirugía como si no, exige que te expliquen la opción de cirugía transoral. Existe la obligación ética y legal de hacerlo. Si el tumor es resecable eres un candidato potencial.
- Si eres un profesional implicado en el manejo del cáncer de orofaringe y no tienes muy claro de qué te estoy hablando, es posible que no estés ofreciendo a tus pacientes la mejor opción de tratamiento posible.
- Si eres gestor, eres en realidad el último responsable. La manera más eficiente de gestionar el cáncer de orofaringe pasa por la cirugía transoral, sea cual sea tu contexto (público o privado, tengas o no sistema de cirugía robótica en tu hospital).
J Granell. 7 de julio de 2024
PD. Adjunto un listado de referencias sobre cáncer de orofaringe y cirugía robótica, en orden cronológico.
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Weinstein GS, Quon H, Newman HJ, Chalian JA, Malloy K, Lin A, Desai A, Livolsi VA, Montone KT, Cohen KR, O’Malley BW. Transoral robotic surgery alone for oropharyngeal cancer: an analysis of local control. Arch Otolaryngol Head Neck Surg. 2012 Jul;138(7):628-34. doi: 10.1001/archoto.2012.1166
Genden EM. The role for surgical management of HPV-related oropharyngeal carcinoma. Head Neck Pathol. 2012 Jul;6 Suppl 1:S98-103″
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Smartt JM Jr, Gerety P, Serletti JM, Taylor JA. Application of a robotic telemanipulator to perform posterior pharyngeal flap surgery: a feasibility study. Plast Reconstr Surg. 2013 Apr;131(4):841-5
Dallan I, Seccia V, Faggioni L, Castelnuovo P, Montevecchi F, Casani AP, Tschabitscher M, Vicini C. Anatomical landmarks for transoral robotic tongue base surgery: comparison between endoscopic, external and radiological perspectives. Surg Radiol Anat, 2013; 35:3–10
Kayhan FT, Kaya KH, Koc AK, Altintas A, Erdur O. Transoral surgery for an infant thyroglossal duct cyst. Int J Pediatr Otorhinolaryngol. 2013 Sep;77(9):1620-3
Byeon HK, Duvvuri U, Kim WS, Park YM, Hong HJ, Koh YW, Choi EC. Transoral robotic retropharyngeal lymph node dissection with or without lateral oropharyngectomy. J Craniofac Surg. 2013 Jul;24(4):1156-61
Mattheis S, Hoffmann TK, Schuler PJ, Dominas N, Bankfalvi A, Lang S. The Use of a Flexible CO2-Laser Fiber in Transoral Robotic Surgery (TORS). Laryngorhinootologie. 2013 Jul 5. [Epub ahead of print]
Dziegielewski PT, Teknos TN, Durmus K, Old M, Agrawal A, Kakarala K, Marcinow A, Ozer E. Transoral Robotic Surgery for Oropharyngeal Cancer: Long-term Quality of Life and Functional Outcomes. JAMA Otolaryngol Head Neck Surg, 2013;139:1099-108
Nichols AC, Yoo J, Hammond JA, Fung K, Winquist E, Read N, Venkatesan V, MacNeil SD, Ernst DS, Kuruvilla S, Chen J, Corsten M, Odell M, Eapen L, Theurer J, Doyle PC, Wehrli B, Kwan K, Palma DA. Early-stage squamous cell carcinoma of the oropharynx: radiotherapy vs. trans-oral robotic surgery (ORATOR)–study protocol for a randomized phase II trial. BMC Cancer. 2013 Mar 20;13:133. doi: 10.1186/1471-2407-13-133.
Olsen SM, Moore EJ, Laborde RR, Garcia JJ, Janus JR, Price DL, Olsen KD. Transoral surgery alone for human-papillomavirus-associated oropharyngeal squamous cell carcinoma. Ear Nose Throat J. 2013 Feb;92(2):76-83. PMID: 23460216.
White H, Ford S, Bush B, Holsinger FC, Moore E, Ghanem T, Carroll W, Rosenthal E, Magnuson JS. Salvage Surgery for Recurrent Cancers of the Oropharynx: Comparing TORS With Standard Open Surgical Approaches. JAMA Otolaryngol Head Neck Surg. 2013;139:773-778
Park YM, Kim WS, Byeon HK, Choi EC, Kim SH. Comparison of oncologic and functional outcomes after transoral robotic lateral oropharyngectomy versus conventional surgery for T1-T3 tonsillar cancer. Head Neck. 2013 Jul 8. doi: 10.1002/hed.23424.
Park YM, Kim WS, Byeon HK, Lee SY, Kim SH. A novel technique for the resection of the symptomatic lingual thyroid: transoral robotic surgery. Thyroid. 2013;23: 466-471.
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Moore EJ, Hinni ML. Transoral laser microsurgery and robotic-assisted surgery for oropharynx cancer including human papillomavirus-related cancer. Int J Radiat Oncol Biol Phys. 2013 Apr 1;85(5):1163-7
Kofler B, Laban S, Busch CJ, Lörincz B, Knecht. New treatment strategies for HPV-positive head and neck cancer. Eur Arch Otorhinolaryngol. 2014 Jul;271(7):1861-7
Howard BE, Moore EJ, Hinni ML. Lingual thyroidectomy: the mayo clinic experience with transoral laser microsurgery and transoral robotic surgery. Ann Otol Rhinol Laryngol. 2014 ;123:183-187
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Granell J, Mendez-Benegassi I, Millas T, Garrido L, Gutierrez-Fonseca R. Transoral robotic surgery: step-by-step radical tonsillectomy. Case Rep Otolaryngol. 2014;2014:497528.doi: 10.1155/2014/497528. Epub 2014 Apr 6 PMID: 24808963; PMCID: PMC3997998
Lukens JN, Lin A, Gamerman V, Mitra N, Grover S, McMenamin EM, Weinstein GS, O’Malley BW Jr, Cohen RB, Orisamolu A, Ahn PH, Quon H. Late consequential surgical bed soft tissue necrosis in advanced oropharyngeal squamous cell carcinomas treated with transoral robotic surgery and postoperative radiation therapy. Int J Radiat Oncol Biol Phys 2014;89:981-988
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Byeon HK, Holsinger FC, Kim DH, Kim JW, Park JH, Koh YW, Choi EC. Feasibility of robot-assisted neck dissection followed by transoral robotic
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Chung TK, Rosenthal EL, Magnuson JS, Carroll WR. Transoral robotic surgery for oropharyngeal and tongue cancer in the United States. Laryngoscope. 2015 125:140-145. doi: 10.1002/lary.24870.
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Prasad VM, Remacle M, Lawson G. In reference to first use of a computer-assisted operator-controlled flexible endoscope for transoral surgery. Laryngoscope. 2015 Aug;125(8):E291. doi: 10.1002/lary.25184. Epub 2015 Jan 30. PMID: 25640530″
Mydlarz WK, Chan JY, Richmon JD. The role of surgery for HPV-associated head and neck cancer.Oral Oncol. 2015 Apr;51(4):305-13
Tateya I, Ishikawa S, Morita S, Ito H, Sakamoto T, Murayama T, Kishimoto Y, Hayashi T, Funakoshi M, Hirano S, Kitamura M, Morita M, Muto M, Ito J. Magnifying endoscopy with narrow band imaging to determine the extent of resection in transoral robotic surgery of oropharyngeal cancer. Case Rep Otolaryngol. 2014;2014:604737. doi: 10.1155/2014/604737. Epub 2014 Dec 10
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Kucur C, Durmus K, Gun R, Old MO, Agrawal A, Teknos TN, Ozer E. The safety and efficacy of concurrent neck dissection and transoral robotic surgery. Head Neck. 2016 Apr;38 Suppl 1:E519-23. doi: 10.1002/hed.24033. Epub 2015 Jul 6
Choby GW, Kim J, Ling DC, Abberbock S, Mandal R, Kim S, Ferris RL, Duvvuri U. Transoral Robotic Surgery Alone for Oropharyngeal Cancer: Quality-of-Life Outcomes. JAMA Otolaryngol Head Neck Surg. 2015 Apr 2. doi: 10.1001/jamaoto.2015.0347. [Epub ahead of print]
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Kim JH, Hyun CL, Lim GC. Polymorphous low-grade adenocarcinoma of the tongue base treated by transoral robotic surgery. Case Rep Otolaryngol. 2015;2015:981436. doi: 10.1155/2015/981436. Epub 2015 Apr14.
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Meccariello G, Eesa M, Costantini M, Montevecchi F, Vicini C. Tips and Tricks in Transoral Robotic Surgery for Challenging Vascular Tumors. J Craniofac Surg. 2015;26:1616-1618.”
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Funk RK, Moore EJ, García JJ, Harmsen WS, Stoddard DG, Vencio EF, Foote RL, Price KA, Ma DJ. Risk factors for locoregional relapse after transoral robotic surgery for human papillomavirus-related oropharyngeal squamous cell carcinoma. Head Neck. 2015 Dec 15. doi: 10.1002/hed.24298. [Epub ahead of print]
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Gun R, Durmus K, Kucur C, Carrau RL, Ozer E. Transoral Surgical Anatomy and Clinical Considerations of Lateral Oropharyngeal Wall, Parapharyngeal Space, and Tongue Base. Otolaryngol Head Neck Surg. 2016 Jan 26. pii: 0194599815625911. [Epub ahead of print]
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Cracchiolo JR, Baxi SS, Morris LG, Ganly I, Patel SG, Cohen MA, Roman BR. Increase in primary surgical treatment of T1 and T2 oropharyngeal squamous cell carcinoma and rates of adverse pathologic features: National Cancer Data Base.Cancer. 2016 Mar 11. doi: 10.1002/cncr.29938. [Epub ahead of print]
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Fu TS, Foreman A, Goldstein DP, de Almeida JR. The role of transoral robotic surgery, transoral laser microsurgery, and lingual tonsillectomy in the identification of head and neck squamous cell carcinoma of unknown primary origin: a systematic review. J Otolaryngol Head Neck Surg. 2016 4;45:28″
Gildener-Leapman N, Kim J, Abberbock S, Choby GW, Mandal R, Duvvuri U, Ferris RL, Kim S. Utility of up-front transoral robotic surgery in tailoring adjuvant therapy. Head Neck. 2016 May 26. doi: 10.1002/hed.24390. [Epub ahead of print]
Cohen DS, Mutchnick SA, Waxman JA, Patel S, Low GM, Melkane AE, Shkoukani MA, Lin HS. Establishing a danger zone: An anatomic study of the lingual artery in base of tongue surgery. Laryngoscope 2017 Jan;127(1):110-115. doi: 10.1002/lary.26048. Epub 2016 May 30. PMID: 27238879
Crawford JA, Bahgat AY, White HN, Magnuson JS. Hemostatic Options for Transoral Robotic Surgery of the Pharynx and Base of Tongue. Otolaryngol Clin North Am. 2016 Jun;49(3):715-25. doi: 10.1016/j.otc.2016.03.002.
Beitler JJ, Quon H, Jones CU, Salama JK, Busse PM, Cooper JS, Koyfman SA, Ridge JA, Saba NF, Siddiqui F, Smith RV, Worden F, Yao M, Yom SS. ACR Appropriateness Criteria(®) Locoregional therapy for resectable oropharyngeal squamous cell carcinomas. Head Neck. 2016 Jun 22. doi: 10.1002/hed.24447. [Epub ahead of print]
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Sharma A, Patel S, Baik FM, Mathison G, Pierce BH, Khariwala SS, Yueh B, Schwartz SM, Méndez E. Survival and Gastrostomy Prevalence in Patients With Oropharyngeal Cancer Treated With Transoral Robotic Surgery vs Chemoradiotherapy.JAMA Otolaryngol Head Neck Surg. 2016 Jun 23. doi: 10.1001/jamaoto.2016.1106.[Epub ahead of print]
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Cracchiolo JR, Roman BR, Kutler DI, Kuhel WI, Cohen MA. Adoption of transoral robotic surgery compared with other surgical modalities for treatment of oropharyngeal squamous cell carcinoma. J Surg Oncol. 2016 Jul 8. doi: 10.1002/jso.24353. [Epub ahead of print]
Sload R, Silver N, Jawad BA, Gross ND. The Role of Transoral Robotic Surgery in the Management of HPV Negative Oropharyngeal Squamous Cell Carcinoma. Curr Oncol Rep. 2016;18:53.
Weaver AN, Cooper TS, Wei S, Carroll WR, Rosenthal EL, Yang ES. DNA-PkCS expression in oropharyngeal squamous cell carcinoma: Correlations with human papillomavirus status and recurrence after transoral robotic surgery. Head Neck. 2016 Aug 10. doi: 10.1002/hed.24562. [Epub ahead of print]
Krishnan SG, Umapathysivam K, Lockwood C, Hodge JC. Oncological and survival outcomes following transoral robotic surgery versus transoral laser microsurgery for the treatment of oropharyngeal squamous cell carcinoma: a systematic review protocol. JBI Database System Rev Implement Rep. 2016 Aug;14(8):90-102.”
Ling DC, Chapman BV, Kim J, Choby GW, Kabolizadeh P, Clump DA, Ferris RL, Kim S, Beriwal S, Heron DE, Duvvuri U. Oncologic outcomes and patient-reported quality of life in patients with oropharyngeal squamous cell carcinoma treated with definitive transoral robotic surgery versus definitive chemoradiation. Oral Oncol. 2016 Oct;61:41-6. doi: 10.1016/j.oraloncology.2016.08.004. Epub 2016 Aug 25.
Lam J, Scott G, Palma DA, Fung K, Louie AV. Patient Preferences in Early Oropharyngeal Cancer Treatment: Transoral Robotic Surgery (TORS) Versus Radiation Therapy. Int J Radiat Oncol Biol Phys. 2016 Oct 1;96(2S):S219-S220. doi:10.1016/j.ijrobp.2016.06.546.
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Carey RM, Brody RM, Shimunov D, Shinn JR, Mady LJ, Rajasekaran K, Cannady SB, Lin A, Lukens JN, Bauml JM, Cohen RB, Basu D, O’Malley BW Jr, Weinstein GS, Newman JG. Locoregional Recurrence in p16-Positive Oropharyngeal Squamous Cell Carcinoma After TORS. Laryngoscope. 2021 Jun 2. doi: 10.1002/lary.29659. Epub ahead of print. PMID: 34076275
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Dunlap Q, Mitchell WM, Gardner JR, King D, Samant R, Moreno M, Vural E. Vascularity Outcomes of Lingual Artery Ligation in Transoral Robotic Base of Tongue Resections. Otolaryngol Head Neck Surg. 2022 Apr;166(4):684-687. doi: 10.1177/01945998211017446. Epub 2021 Jun 8. PMID: 34098802.
Gaino F, Gorphe P, Vander Poorten V, Holsinger FC, Lira RB, Duvvuri U, Garrel R, Van Der Vorst S, Cristalli G, Ferreli F, De Virgilio A, Giannitto C, Morenghi E, Colombo G, Malvezzi L, Spriano G, Mercante G. Preoperative predictors of difficult oropharyngeal exposure for transoral robotic surgery: The Pharyngoscore. Head Neck. 2021 Jun 16. doi: 10.1002/hed.26792. Epub ahead of print. PMID: 34132440
Sun L, Shimunov D, Tan EX, Swisher-Mcclure S, Lin A, Lukens JN, Basu D, Chalian AA, Cannady SB, Newman JG, Rajasekaran K, O’Malley BW Jr, Rassekh CH, Weinstein GS, Loevner LA, Aggarwal C, Singh A, Cohen RB, Bauml JM, Brody RM. Survival and toxicity in patients with human papilloma virus-associated oropharyngeal squamous cell cancer receiving trimodality therapy including transoral robotic surgery. Head Neck. 2021 Jun 25. doi: 10.1002/hed.26797. Epub ahead of print. PMID: 34170052
Feng AL, Holcomb AJ, Abt NB, Mokhtari TE, Suresh K, McHugh CI, Parikh AS, Holman A, Kammer RE, Goldsmith TA, Faden DL, Deschler DG, Varvares MA, Lin DT, Richmon JD. Feeding Tube Placement Following Transoral Robotic Surgery for Oropharyngeal Squamous Cell Carcinoma. Otolaryngol Head Neck Surg. 2021 Jun 22:1945998211020302. doi: 10.1177/01945998211020302. Epub ahead of print. PMID: 34154449
Frederiksen JG, Channir HI, Larsen MHH, Christensen A, Friborg J, Charabi BW, Rubek N, von Buchwald C. Long-term survival outcomes after primary transoral robotic surgery (TORS) with concurrent neck dissection for early-stage oropharyngeal squamous cell carcinoma. Acta Otolaryngol. 2021 Jul;141(7):714-718. doi: 10.1080/00016489.2021.1939147. Epub 2021 Jun 30. PMID: 34191671
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Kim C, Martinez E, Kulich M, Swanson MS. Surgeon practice patterns in transoral robotic surgery for HPV-related oropharyngeal cancer. Oral Oncol. 2021 Jul 20;121:105460. doi: 10.1016/j.oraloncology.2021.105460. Epub ahead of print. PMID: 34298289
Bollig CA, Wang K, Llerena P, Puram SV, Pipkorn PJ, Jackson RS, Stubbs VC. National Analysis of Oropharyngeal Salivary Gland Malignancies Treated With Transoral Robotic Surgery. Otolaryngol Head Neck Surg. 2021 Jul 27:1945998211031161. doi: 10.1177/01945998211031161. Epub ahead of print. PMID: 34311621
Daigle O, Gardner JR, King D, Moreno MA, Sunde J, Vural E. Preemptive Utilization of Anterior Belly of the Digastric Muscle Flaps in Transoral Robotic Radical Tonsillectomy. OTO Open. 2021 Aug 5;5(3):2473974X211035102. doi: 10.1177/2473974X211035102. PMID: 34396028; PMCID: PMC8358520″
Wright CM, Lee DY, Shimunov D, Carmona R, Barsky AR, Sun L, Cohen RB, Bauml JM, Brody RM, Basu D, Rassekh CH, Chalian AA, Newman JG, Rajasekaran K, Weinstein GS, Lukens JN, Lin A, Swisher-McClure S. Definitive tumor directed therapy confers a survival advantage for metachronous oligometastatic HPV-associated oropharyngeal cancer following trans-oral robotic surgery. Oral Oncol. 2021 Aug 30;121:105509. doi: 10.1016/j.oraloncology.2021.105509. Epub ahead of print. PMID: 34474270
Philips R, Sagheer H, Barsouk A, Swendseid B, Johnson J, Bar Ad V, Luginbuhl A, Curry J, Cognetti D. Trends in Adjuvant Therapy After Surgery for Oropharyngeal Squamous Cell Carcinoma. Laryngoscope. 2021 Sep 23. doi: 10.1002/lary.29870. Epub ahead of print. PMID: 34553790
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Groysman M, Yi SK, Robbins JR, Hsu CC, Julian R, Bauman JE, Baker A, Wang SJ, Bearelly S. The impact of socioeconomic and geographic factors on access to transoral robotic/endoscopic surgery for early stage oropharyngeal malignancy. Am J Otolaryngol. 2021 Sep 16;43(1):103243. doi: 10.1016/j.amjoto.2021.103243. Epub ahead of print. PMID: 34583290″
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Kaffenberger TM, Patel AK, Lyu L, Li J, Wasserman-Wincko T, Zandberg DP, Clump DA, Johnson JT, Nilsen ML. Quality of life after radiation and transoral robotic surgery in advanced oropharyngeal cancer. Laryngoscope Investig Otolaryngol. 2021 Sep 16;6(5):983-990. doi: 10.1002/lio2.628. PMID: 34667840; PMCID: PMC8513430″
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Parimbelli E, Soldati F, Duchoud L, Armas GL, de Almeida J, Broglie M, Quaglini S, Simon C. Cost-utility of two minimally-invasive surgical techniques for operable oropharyngeal cancer: transoral robotic surgery versus transoral laser microsurgery. BMC Health Serv Res. 2021 Oct 29;21(1):1173. doi: 10.1186/s12913-021-07149-x.”
Lee DY, Wright CM, Shimunov D, Carmona R, Barsky AR, Sun L, Cohen R, Bauml J, Brody R, Basu D, Rassekh C, O’Malley B, Chalian A, Newman J, Rajasekaran K, Weinstein GS, Lukens JN, Lin A, Swisher-McClure SD. Definitive Tumor Directed Therapy for Metachronous Oligometastatic HPV-Associated Oropharyngeal Cancer Following Trans-Oral Robotic Surgery. Int J Radiat Oncol Biol Phys. 2021 Nov 1;111(3S):e403. doi: 10.1016/j.ijrobp.2021.07.1165. PMID: 34701371″
Maxwell RJL, Poirier K, Montone K, Swisher-McClure SD, Kumar S, Kuperwasser C, Bauml J, Cohen R, Newman J, Brody R, Rajasekaran K, Chalian A, Rassekh C, Weinstein GS, Lin A, Lukens JN. Detection of Plasma Circulating Tumor-Tissue Modified HPV DNA Following Trans-Oral Robotic Surgery (TORS) and Neck Dissection for p16+ Oropharyngeal Squamous Cell Carcinoma. Int J Radiat Oncol Biol Phys. 2021 Nov 1;111(3S):e402. doi: 10.1016/j.ijrobp.2021.07.1163. PMID: 34701369
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Shinn JR, Carey RM, Mady LJ, Shimunov D, Parhar HS, Cannady SB, Rajasekaran K, Lukens JN, Lin A, Swisher-McClure S, Cohen RB, Bauml JM, Rassekh CH, Newman JG, Chalian AA, Basu D, Weinstein GS, Brody RM. Sex-based differences in outcomes among surgically treated patients with HPV-related oropharyngeal squamous cell carcinoma. Oral Oncol. 2021 Oct 29;123:105570. doi: 10.1016/j.oraloncology.2021.105570. Epub ahead of print. PMID: 34742005
Barbon CEA, Yao CMK, Peterson CB, Moreno AC, Goepfert RP, Johnson FM, Chronowski GM, Fuller CD, Gross ND, Hutcheson KA. Swallowing After Primary TORS and Unilateral or Bilateral Radiation for Low- to Intermediate-Risk Tonsil Cancer. Otolaryngol Head Neck Surg. 2021 Nov 16:1945998211059967. doi: 10.1177/01945998211059967. Epub ahead of print. PMID: 34784256.
Dhere VR, Escott CE, Tian S, Switchenko JM, Bell JP, Stokes WA, McDonald MW, Magliocca KR, Boyce BJ, Kaka AS, Steuer CE, Saba NF, Shin DM, Xiao C, Patel MR, Beitler JJ. The omission of intentional primary site radiation following transoral robotic surgery in 59 patients: No local-regional failures. Head Neck. 2021 Dec 1. doi: 10.1002/hed.26928. Epub ahead of print. PMID: 34850994
Sahovaler A, Lee JJW, Xu W, Su S, Hosni A, Bayley A, Goldstein DP, de Almeida JR. Contralateral nodal failures in oropharyngeal cancers after TORS and unilateral neck management: a retrospective study. J Otolaryngol Head Neck Surg. 2021 Dec 23;50(1):71. doi: 10.1186/s40463-021-00551-9. PMID: 34949220
Nichols AC, Theurer J, Prisman E, Read N, Berthelet E, Tran E, Fung K, de Almeida JR, Bayley A, Goldstein DP, Hier M, Sultanem K, Richardson K, Mlynarek A, Krishnan S, Le H, Yoo J, MacNeil SD, Winquist E, Hammond JA, Venkatesan V, Kuruvilla S, Warner A, Mitchell S, Chen J, Corsten M, Johnson-Obaseki S, Odell M, Parker C, Wehrli B, Kwan K, Palma DA. Randomized Trial of Radiotherapy Versus Transoral Robotic Surgery for Oropharyngeal Squamous Cell Carcinoma: Long-Term Results of the ORATOR Trial. J Clin Oncol. 2022 Mar 10;40(8):866-875. doi: 10.1200/JCO.21.01961
Davies JC, Husain Z, Day TA, Graboyes EM, Eskander A. Perioperative Mortality Risk in Patients Undergoing Transoral Robotic Surgery for T1-T2 Oropharyngeal Squamous Cell Carcinoma: A National Cancer Database Study. Front Oncol. 2022 Jan 6;11:808465. doi: 10.3389/fonc.2021.808465. PMID: 35071012; PMCID: PMC8770260
Meccariello G, Cammaroto G, Iannella G, De Vito A, Ciorba A, Bianchini C, Corazzi V, Pelucchi S, Vicini C, Capaccio P. Transoral robotic surgery for oropharyngeal cancer in the era of chemoradiation therapy. Auris Nasus Larynx. 2022 Jan 28:S0385-8146(22)00029-3. doi: 10.1016/j.anl.2022.01.011. Epub ahead of print. PMID: 35101284
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Bollig CA, Morris B, Stubbs VC. Transoral robotic surgery with neck dissection versus nonsurgical treatment in stage I and II human papillomavirus-negative oropharyngeal cancer. Head Neck. 2022 Apr 1. doi: 10.1002/hed.27045. Epub ahead of print. PMID: 35365915
Nagel TH, Chang BA, Hinni ML. Robotic vs. transoral laser surgery of malignant oropharyngeal tumors-what is best for the patient? : A contemporary review. HNO. 2022 Apr 13. English. doi: 10.1007/s00106-022-01165-x. Epub ahead of print. PMID: 35419634
Wadhavkar N, Jorgensen JB, Bollig CA. Association of comorbidity score with perioperative outcomes following transoral robotic surgery: National analysis. Head Neck. 2022 Apr 29. doi: 10.1002/hed.27070. Epub ahead of print. PMID: 35484962
Weyers BW, Birkeland AC, Marsden MA, Tam A, Bec J, Frusciante RP, Gui D, Bewley AF, Abouyared M, Marcu L, Farwell DG. Intraoperative delineation of p16+ oropharyngeal carcinoma of unknown primary origin with fluorescence lifetime imaging: Preliminary report. Head Neck. 2022 May 5. doi: 10.1002/hed.27078. Epub ahead of print. PMID: 35511208
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Zorzi SF, Agostini G, Chu F, Tagliabue M, Pietrobon G, Corrao G, Volpe S, Marvaso G, Colombo F, Rocca MC, Gandini S, Gaeta A, Ruju F, Alterio D, Ansarin M. Upfront transoral robotic surgery (TORS) versus intensity-modulated radiation therapy (IMRT) in HPV-positive oropharyngeal cancer: real-world data from a tertiary comprehensive cancer center. Acta Otorhinolaryngol Ital. 2022 Aug 8. doi: 10.14639/0392-100X-N2144. Epub ahead of print. PMID: 35938555
Charters E, Pelham C, Novakovic D, Madill C, Clark J. Velopharyngeal incompetence following transoral robotic surgery for oropharyngeal carcinoma: A scoping review. Int J Speech Lang Pathol. 2022 Aug 17:1-9. doi: 10.1080/17549507.2022.2104927. Epub ahead of print. PMID: 35975948
Gupta KK, Garas G, Idle M, Germain S, De M. Evaluating the role of the self-assembling topical haemostat PuraBond® in Transoral Robotic Surgery (TORS) for oropharyngeal cancer: A case series. Ann Med Surg (Lond). 2022 Aug 1;80:104302. doi: 10.1016/j.amsu.2022.104302. PMID: 36045860; PMCID: PMC9422351
Siddiq S, Stephen S, Lin D, Fox H, Robinson M, Paleri V. Robotic lateral oropharyngectomy following diagnostic tonsillectomy is oncologically safe in patients with human papillomavirus-related squamous cell cancer: Long-term results. Head Neck. 2022 Sep 3. doi: 10.1002/hed.27186. Epub ahead of print. PMID: 36056651
Chai RL, Ferrandino RM, Barron C, Donboli K, Roof SA, Khan MN, Teng MS, Posner MR, Bakst RL, Genden EM. The Sinai Robotic Surgery Trial in HPV-related oropharyngeal squamous cell carcinoma (SIRS 2.0 trial) – study protocol for a phase II non-randomized non-inferiority trial. Front Oncol. 2022 Aug 25;12:965578. doi: 10.3389/fonc.2022.965578. PMID: 36091121; PMCID: PMC9453550″
Yu AC, Afework DD, Goldstein JD, Abemayor E, Mendelsohn AH. Association of Intraoperative Frozen Section Controls With Improved Margin Assessment During Transoral Robotic Surgery for Human Papillomavirus-Positive Oropharyngeal Squamous Cell Carcinoma. JAMA Otolaryngol Head Neck Surg. 2022 Sep 22. doi: 10.1001/jamaoto.2022.2840. Epub ahead of print. PMID: 36136328
Scott SI, Madsen AKØ, Rubek N, Charabi BW, Wessel I, Jensen CV, Friborg J, von Buchwald C. Dysphagia and QoL 3 Years After Treatment of Oropharyngeal Cancer With TORS or Radiotherapy. Laryngoscope. 2022 Oct 14. doi: 10.1002/lary.30410. Epub ahead of print. PMID: 36239625
Hemmati M, Barbon C, Mohamed ASR, van Dijk LV, Moreno AC, Gross ND, Goepfert RP, Lai SY, Hutcheson KA, Schaefer AJ, Fuller CD; MD Anderson Head and Neck Cancer Symptom Working Group. Optimized decision support for selection of transoral robotic surgery or (chemo)radiation therapy based on posttreatment swallowing toxicity. Cancer Med. 2022 Oct 13. doi: 10.1002/cam4.5253. Epub ahead of print. PMID: 36229990″
Tapia M, Manji J, Dhillon K, Kleid S, Flatman S, Prasad J, Cardin A, Fua T, Rischin D, Dixon B, J R Magarey M. The negative predictive value of FDG PET/CT staging in early oropharyngeal squamous cell carcinoma and implications to transoral robotic surgery patient selection. Oral Oncol. 2022 Oct 20;135:106213. doi: 10.1016/j.oraloncology.2022.106213. Epub ahead of print. PMID: 36274346″
Panda NK, Kapoor A, Goel N, Ghoshal S, Singh V, Bal A. Analysis of Outcomes following TORS in a Mixed Cohort of Recurrent and New T1-T2 Oropharyngeal Cancer- A Single Institution Study. Indian J Otolaryngol Head Neck Surg. 2022 Dec;74(4):555-563. doi: 10.1007/s12070-022-03139-5. Epub 2022 Sep 9. PMID: 36514439; PMCID: PMC9741672
Janopaul-Naylor JR, Rupji M, Tobillo RA, Lorenz JW, Switchenko JM, Tian S, Kaka AS, Qian DC, Schlafstein AJ, Steuer CE, Remick JS, Rudra S, McDonald MW, Saba NF, Stokes WA, Patel MR, Bates JE. Ninety-day mortality following transoral robotic surgery or radiation at Commission on Cancer-accredited facilities. Head Neck. 2022 Dec 22. doi: 10.1002/hed.27282. Epub ahead of print. PMID: 36549012
Lee YK, Manek R, Hardman J, Ghedia R, Hariri A, Lacey O, Harrington K, Paleri V. Transoral robotic surgery in a modified Trendelenburg position for oropharyngeal squamous cell carcinoma in a patient with severe thoracic kyphosis. Head Neck. 2022 Dec 22. doi: 10.1002/hed.27271. Epub ahead of print. PMID: 36549002
Magliocca KR, Kaka AS, Barrow EM, Studer MB, Griffith CC, Ernst J, Meade T, Balicki A, Boyce BJ, Schmitt NC, Bur AM, Schmitt AC, Jackson R, Steuer CE, Beitler JJ, Patel MR. Specimen-Based Resection Margins and Local Control during Transoral Robotic Surgery for Oropharyngeal HPV-Mediated Squamous Cell Carcinoma. ORL J Otorhinolaryngol Relat Spec. 2022 Dec 20:1-8. doi: 10.1159/000527369. Epub ahead of print. PMID: 36538901
Berania I, Hosni A, Thomas CM, Goldstein D, Bayley A, Mohan R, Hendler A, Cooper RM, de Almeida JR. Evaluating contralateral neck failure in patients with lateralized OPSCC treated with transoral robotic surgery and neck management based on pre-operative SPECT-CT lymphatic mapping. J Otolaryngol Head Neck Surg. 2022 Dec 27;51(1):47. doi: 10.1186/s40463-022-00563-z. PMID: 36575528; PMCID: PMC9795590
Cho KJ, Park JO, Joo YH, Nam IC. Role of local flaps in the prevention of soft tissue necrosis after transoral robotic surgery for tonsillar cancer. Auris Nasus Larynx. 2022 Dec 24:S0385-8146(22)00234-6. doi: 10.1016/j.anl.2022.12.006. Epub ahead of print. PMID: 36572574
Haller TJ, Yin XL, O’Byrne TJ, Moore EJ, Ma DJ, Price KP, Patel SH, Hinni ML, Neben-Wittich MA, McGee LA, Price DL, Janus JR, Kasperbauer JK, Nagel TH, Routman DM, Lester SC, Rwigema JCM, Chintakuntlawar AV, Savvides PS, Garcia JJ, Foote RL, Van Abel KM. 30-day morbidity and mortality after transoral robotic surgery for human papillomavirus (HPV) associated oropharyngeal squamous cell carcinoma: A retrospective analysis of two prospective adjuvant de-escalation trials (MC1273 & MC1675). Oral Oncol. 2023 Jan 3;137:106248. doi: 10.1016/j.oraloncology.2022.106248. Epub ahead of print. PMID: 36603364.”
Berlin E, Ma DJ, Bakst RL, Quon H, Lin A, Lukens JN. Close Margins Following Transoral Robotic Surgery (TORS) for HPV+ Oropharyngeal Carcinoma: A review of the literature and practical recommendations. Pract Radiat Oncol. 2023 Jan 1:S1879-8500(22)00390-3. doi: 10.1016/j.prro.2022.12.005. Epub ahead of print. PMID: 36599392.
Dabas SK, Padhiari R, Sharma A, Ranjan R, Shukla H, Gurung B, Chadda Y, Subash A. Modified Preauricular Cervico-facial Approach for Oral Cancers: an Analysis of Oncological and Functional Outcomes. Indian J Surg Oncol. 2022 Dec;13(4):696-701. doi: 10.1007/s13193-022-01538-2. Epub 2022 May 7. PMID: 36687235; PMCID: PMC9845475
Kumar S, Laugharne D, Mortimore S. Revision Transoral Robotic Surgery for Early Stage HPV Positive Oropharyngeal Squamous Cell Carcinoma, it’s Timing and Margins: Past and Present- a Prospective Single Centre Observational Study. Indian J Otolaryngol Head Neck Surg. 2022 Dec;74(Suppl 3):6236-6240. doi: 10.1007/s12070-021-02926-w. Epub 2021 Nov 5. PMID: 36742575; PMCID: PMC9895688
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De Virgilio A, Costantino A, Rizzo D, Crescio C, Gallus R, Spriano G, Mercante G, Festa BM, Accorona R, Pignataro L, Capaccio P, Bussu F. Do We Have Enough Evidence to Specifically Recommend Transoral Robotic Surgery in HPV-Driven Oropharyngeal Cancer? A Systematic Review. Pathogens. 2023 Jan 18;12(2):160. doi: 10.3390/pathogens12020160. PMID: 36839432; PMCID: PMC9959572
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Khurana N, Babajanian E, McCrary H, Pulsipher A, Ghandehari H, Alt JA, Cannon RB. Vascular permeability in HPV+ oropharyngeal cancers aids in fluorescent image-guided transoral robotic surgery using indocyanine green. Head Neck. 2023 May 9. doi: 10.1002/hed.27384. Epub ahead of print. PMID: 37158163
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Cannavicci A, Cioccoloni E, Moretti F, Cammaroto G, Iannella G, De Vito A, Sgarzani R, Gessaroli M, Ciorba A, Bianchini C, Corazzi V, Capaccio P, Vicini C, Meccariello G. Single centre analysis of perioperative complications in trans-oral robotic surgery for oropharyngeal carcinomas. Indian J Otolaryngol Head Neck Surg. 2023 Jun;75(2):842-847. doi: 10.1007/s12070-023-03518-6. Epub 2023 Feb 5. PMID: 37275059; PMCID: PMC10235366
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Callander JK, Clark AJ, Dillon W, Ryan WR. Spondylodiscitis and Spinal Epidural Abscess After Transoral Robotic Surgery Radical Tonsillectomy. OTO Open. 2023 Jun 21;7(2):e61. doi: 10.1002/oto2.61. PMID: 37351270; PMCID: PMC10284497
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Wong BYW, Jose J. Letter to Editor: Comparison of margins and survival between transoral robotic surgery (TORS) and non-robotic endoscopic surgery for oropharyngeal cancer. Am J Otolaryngol. 2024 Jan 17;45(3):104225. doi: 10.1016/j.amjoto.2024.104225. Epub ahead of print. PMID: 38246100.
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Kwon JJY, Liu AQ, Milner TD, Prisman E. Decisional regret, symptom burden, and quality of life following transoral robotic surgery for oropharyngeal cancer. Oral Oncol. 2023 Aug 12;146:106537. doi: 10.1016/j.oraloncology.2023.106537. Epub ahead of print. PMID: 37579543.
Silva Cunha JL. Comment on “”Decisional regret, symptom burden, and quality of life following transoral robotic surgery for oropharyngeal cancer””. Oral Oncol. 2023 Nov 9;147:106626. doi: 10.1016/j.oraloncology.2023.106626. Epub ahead of print. PMID: 37951117
Hughes RT, Levine BJ, May N, Shenker RF, Yang JH, Lanier CM, Frizzell BA, Greven KM, Waltonen JD. Survival and Swallowing Function after Primary Radiotherapy versus Transoral Robotic Surgery for Human Papillomavirus-Associated Oropharyngeal Squamous Cell Carcinoma. ORL J Otorhinolaryngol Relat Spec. 2023 Aug 30:1-10. doi: 10.1159/000531995. Epub ahead of print. PMID: 37647863
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Costantino A, Sampieri C, Meliante PG, De Virgilio A, Kim SH. Transoral robotic surgery in oropharyngeal squamous cell carcinoma: A comparative study between da Vinci Single-Port and da Vinci Xi systems. Oral Oncol. 2023 Nov 14;148:106629. doi: 10.1016/j.oraloncology.2023.106629. Epub ahead of print. PMID: 37972462
de Araújo Lopes NV, Alves PM, Silva Cunha JL. Comment on “”Transoral robotic surgery in oropharyngeal squamous cell carcinoma: A comparative study between da Vinci Single-Port and da Vinci Xi systems””. Oral Oncol. 2023 Dec 12;148:106653. doi: 10.1016/j.oraloncology.2023.106653. Epub ahead of print. PMID: 38091682.
Costantino A, Sampieri C, Meliante PG, De Virgilio A, Kim SH. Reply to: Comment on “”Transoral robotic surgery in oropharyngeal squamous cell carcinoma: A comparative study between da Vinci Single-Port and da Vinci Xi systems””. Oral Oncol. 2024 Feb 1;150:106700. doi: 10.1016/j.oraloncology.2024.106700. Epub ahead of print. PMID: 38306755″
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Silver JA, Bouganim N, Richardson K, Henry M, Mascarella MA, Ramirez-GarciaLuna J, Golabi N, Mlynarek AM, Zeitouni A, Hier MP, Caglar D, Esfahani K, Sadeghi N. Quality of Life After Neoadjuvant Chemotherapy and Transoral Robotic Surgery for Oropharynx Cancer. JAMA Otolaryngol Head Neck Surg. 2023 Dec 7:e233781. doi: 10.1001/jamaoto.2023.3781. Epub ahead of print. PMID: 38060238; PMCID: PMC10704343
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Sadeghi N, Mascarella M, Bouganim N. Neoadjuvant Chemotherapy and Transoral Robotic Surgery for Oropharynx Cancer and Quality of Life-Reply. JAMA Otolaryngol Head Neck Surg. 2024 Apr 11. doi: 10.1001/jamaoto.2024.0480. Epub ahead of print. PMID: 38602686
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Parvathaneni A, Patel SA, Houlton JJ, Pang J, Futran ND. Clarification of the margin status by the multidisciplinary tumor board following transoral robotic surgery for p16 positive oropharyngeal squamous cell carcinoma. Laryngoscope Investig Otolaryngol. 2023 Oct 6;8(6):1500-1506. doi: 10.1002/lio2.1163. PMID: 38130253; PMCID: PMC10731506″
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Battisti A, Della Monaca M, Di Giorgio D, Priore P, Terenzi V, Valentini V. Extranodal follicular dendritic cell sarcoma of the tonsil: An extremely rare clinical entity. Oral Oncol. 2024 Jan 14;149:106690. doi: 10.1016/j.oraloncology.2024.106690. Epub ahead of print. PMID: 38224644″
Ji YB, Choi HW, Song CM, Yun BR, Park HJ, Oh S, Tae K. Long-term functional swallowing and speech outcomes after transoral robotic surgery for oropharyngeal cancer. Front Surg. 2024 Jan 31;11:1362654. doi: 10.3389/fsurg.2024.1362654. PMID: 38357192; PMCID: PMC10864447
Anderson BJ, Moreno AC, Qing Y, Lee JJ, Johnson FM, Lango MN, Barbon CEA, Tripuraneni L, Sahli A, Piper V, Gross N, Fuller CD, Lai SY, Myers JN, Hutcheson KA. Revisiting Feeding Tube Utilization in Oropharynx Cancer: 6-Year Prospective Registry Analysis. Otolaryngol Head Neck Surg. 2024 Feb 14. doi: 10.1002/ohn.672. Epub ahead of print. PMID: 38353360
Maza G, Sharma A. Topical Hemostatic Agents and Risk of Postoperative Hemorrhage After Transoral Robotic Surgery. Ear Nose Throat J. 2024 Feb 21:1455613241233097. doi: 10.1177/01455613241233097. Epub ahead of print. PMID: 38380626
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Malard O, Karakachoff M, Ferron C, Hans S, Vergez S, Garrel R, Gorphe P, Ramin L, Santini L, Villeneuve A, Lasne-Cardon A, Espitalier F, Hounkpatin A. Oncological and functional outcomes for transoral robotic surgery following previous radiation treatment for upper aerodigestive tract head and neck cancers. A French multicenter GETTEC group study. Cancer Med. 2024 Apr;13(7):e7031. doi: 10.1002/cam4.7031. PMID: 38545809; PMCID: PMC10974718″
Meldgaard Justesen M, Kronberg Jakobsen K, Fenger Carlander AL, Hjordt Holm Larsen M, Wessel I, Kiss K, Friborg J, Ibrahim Channir H, Rubek N, Grønhøj C, von Buchwald C. Outcomes of transoral robotic surgery for early-stage oropharyngeal squamous cell carcinoma with low rates of adjuvant therapy: A consecutive single-institution study from 2013 to 2020. Oral Oncol. 2024 Apr 2;152:106783. doi: 10.1016/j.oraloncology.2024.106783. Epub ahead of print. PMID: 38569317
Dharmalingam Jothinathan MK. Outcomes of transoral robotic surgery for early-stage oropharyngeal squamous cell carcinoma with low rates of adjuvant therapy: A consecutive single-institution study from 2013 to 2020. Oral Oncol. 2024 Apr 17;152:106811. doi: 10.1016/j.oraloncology.2024.106811. Epub ahead of print. PMID: 38636137.
Chen RH, Liang FY, Han P, Lin PL, Lin XJ, Wang JY, Kong XW, Huang XM. [Preliminary outcomes of neoadjuvant chemo-immunotherapy combined with transoral robotic surgery for locally advanced oropharyngeal squamous cell carcinoma]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2024 Apr 8;59:329-334. Chinese. doi: 10.3760/cma.j.cn115330-20231205-00273. Epub ahead of print. PMID: 38599642″
Pershad AR, Thakkar PG, Goodman JF, Joshi A, Steinberg SM, Allen CT, Floudas CS. Risk of recurrence after neoadjuvant chemotherapy and transoral robotic surgery in patients with oropharynx cancer that avoid adjuvant radiation. Cancer Med. 2024 Apr;13(7):e7146. doi: 10.1002/cam4.7146. PMID: 38581118; PMCID: PMC10997843
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Dewey J, Shaikh N, Al-Asadi Z, Turner M. The influence of perioperative enoxaparin on bleeding after TORS oropharyngectomy. J Robot Surg. 2024 May 7;18(1):203. doi: 10.1007/s11701-024-01965-z. PMID: 38713415″
Cantore I, Cianfrone F, Tauro F, Bevilacqua P, Tilli M, Lo Verde S, Ruscito P. Transoral robotic surgery tongue base debulking in Castleman’s disease. Acta Otorhinolaryngol Ital. 2024 May 3. doi: 10.14639/0392-100X-N2833. Epub ahead of print. PMID: 38712771
Hunter CJ, Romaniw NN, Beckham R, Farsi S, Benefield A, Solverson M, Gray EA, Nguyen E, Marshall A, King D, Sunde J, Moreno M, Vural E. Utility of video fluoroscopic swallow study in advancing oral diet post TORS for oropharyngeal malignancies. Am J Otolaryngol. 2024 Apr 30;45(4):104336. doi: 10.1016/j.amjoto.2024.104336. Epub ahead of print. PMID: 38704947″
Molteni G, Bassani S, Arsie AE, Zampieri E, Mannelli G, Orlandi E, Bossi P, De Virgilio A. Role of TORS as De-Escalation Strategy in HPV-Related Oropharyngeal Cancer, What We Need to Know. Healthcare (Basel). 2024 May 14;12(10):1014. doi: 10.3390/healthcare12101014. PMID: 38786424; PMCID: PMC11121063
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