What´s new in PubMed this week
Tong JY, Bzhilyanskaya V, Ferris MJ, Molitoris JK, Hatten KM. Adjuvant Proton Radiation Following Transoral Robotic Surgery for HPV-Positive Oropharyngeal Squamous Cell Carcinoma. Otolaryngol Head Neck Surg. 2025 Jan 31. doi: 10.1002/ohn.1150. Epub ahead of print. PMID: 39887800.
Upon reading the abstract, the fist word that came to my mind was “overtreatment“. And it not a thought against Proton Therapy, neither about efficiency.
47 patients, 2017 through 2023. Checking the paper, almost all of them were T1-T2 (95,7%) and N2 (87,2%). Therefore, I understand that the reason for giving adjuvant treatment (radiation) was extranodal extension or adverse histologic features (eg. lymphovascular invasion). Although this might be compliant with current protocols many of us are prompted to believe that probably many of the patients in this series could have been TORS alone.
Ganesh PS, Pathoor NN, Gopal RK. Reflection on Transoral Robotic Surgery vs Transoral Laser Microsurgery in HPV-Positive Oropharyngeal Squamous Cell Carcinoma. JAMA Otolaryngol Head Neck Surg. 2025 Jan 30. doi: 10.1001/jamaoto.2024.5061. Epub ahead of print. PMID: 39883447.
This is a letter.
O’Hara JT, Hurt CN, Jones TM. Reflection on Transoral Robotic Surgery vs Transoral Laser Microsurgery in HPV-Positive Oropharyngeal Squamous Cell Carcinoma-Reply. JAMA Otolaryngol Head Neck Surg. 2025 Jan 30. doi: 10.1001/jamaoto.2024.5064. Epub ahead of print. PMID: 39883455.
And this is the reply.
The original was paper was Transoral Laser or Robotic Surgery Outcomes for Oropharyngeal Carcinoma: Secondary Analysis of the PATHOS Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg. 2024 Oct 10;150(11):1002–11. doi: 10.1001/jamaoto.2024.3371
Chia C, Sharp S, Zhang H, Magarey MJR. Lingual Artery Identification for Ligation in Neck Dissection and Transoral Surgery for Oropharyngeal Tumors. Laryngoscope. 2025 Jan 29. doi: 10.1002/lary.32025. Epub ahead of print. PMID: 39876786.
The authors give an anatomical excuse to justify a paper on a TORS series. “The hypoglossal nerve is a useful landmark for the intraoperative identification of the lingual nerve in elective neck dissection prior to TORS. The lingual artery can be identified either immediately deep to or within 5 mm inferior to the hypoglossal nerve in majority of cases.”
Of course the usual problem in not this one, but finding the lingual artery in the base of the tongue in transoral surgery.
Wagner RT, Khalili S, Henning B, Mundi NS. A Novel Technique for Nasopharyngeal Stenosis Repair: Combined Transoral Robotic and Endonasal Approaches for Enhanced Visualization and Surgical Precision. J Neurol Surg Rep. 2025 Jan 27;86(1):e14-e18. doi: 10.1055/a-2466-7414. PMID: 39872363; PMCID: PMC11772072
Interesting. You can find the full text on Thieme (follow the link).
McArdle E, Bulbul M, Collins C, Duvvuri U, Gross N, Turner M. Surgery for the Treatment of HPV-Negative Oropharyngeal Squamous Cell Carcinoma-A Systematic Review and Meta-Analysis. Head Neck. 2025 Jan 27. doi: 10.1002/hed.28088. Epub ahead of print. PMID: 39866097
Yes, TORS can also be used fot HPV-negative oropharyngeal squamous cell carcinoma (…)
Campo F, Paolini F, Terrenato I, Blandino G, Pascale V, Locca O, Moretto S, Manciocco V, Vidiri A, Venuti A, Pellini R. Circulating HPVDNA in patients undergoing transoral robotic surgery for oropharyngeal cancer: liquid biopsy could identify molecular residual disease. Eur Arch Otorhinolaryngol. 2025 Jan 25. doi: 10.1007/s00405-025-09218-x. Epub ahead of print. PMID: 39863814.
“Liquid biopsy could identify residual molecular disease after surgery and guide clinicians choosing adjuvant treatment”.
Beware, we do not know whether residual molecular disease impacts survival. Many of us suspect it does not.
Holland-Elliott T, Marineni S, Patel N, Ameerally P, Mair M. Novel use of a robot for microvascular anastomosis in head and neck surgery. Br J Oral Maxillofac Surg. 2024 Dec 7:S0266-4356(24)00540-0. doi: 10.1016/j.bjoms.2024.11.009. Epub ahead of print. PMID: 39863444.
Do not be cheated. This is not a surgical robot but a robotic exoscope (RoboticScope, BHS Technologies). Still, another tech new.
J Granell. February 1, 2025.
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