Transoral Robotic Surgery for Oropharyngeal Carcinoma: Update

Background: Oropharyngeal squamous cell carcinoma is increasing in incidence and its epidemiology is evolving to affect more young, HPV+, non-smokers. There have been multiple paradigm shifts in the treatment of this disease. Open surgery has been largely replaced by chemo radiation; however, recently, trans-oral robotic surgery (TORS) is emerging as a new minimally invasive therapeutic modality. Objectives: Update the evidence evaluating TORS in the treatment of or pharyngeal squamous cell carcinoma. Methods: Descriptive review of the literature. Results: Integrating TORS into the multidisciplinary treatment of or pharyngeal squamous cell carcinoma allows carefully selected patients to return home early with intact airway and swallowing function in the majority of cases, without sacrificing oncologic control or survival. These findings compare favorably to open surgery and chemo radiation. Conclusions: TORS appears to be a safe, feasible, and efficacious surgical modality for the treatment of a subset of carefully selected patients with oropharyngeal squamous cell carcinoma. HPV positive non-smokers appear to particularly benefit.