Transoral robotic surgery for oropharyngeal carcinoma: Surgical margins and oncologic outcomes

BackgroundThis study presents oncologic outcomes after transoral robotic surgery (TORS) adjuvant therapy for oropharyngeal squamous cell carcinoma (SCC). MethodsThree hundred fourteen patients undergoing TORS adjuvant therapy for oropharyngeal SCC from May 1, 2007, to May 31, 2015, are analyzed. ResultsMedian follow-up was 3.3 years (interquartile range [IQR] 1.8-5.3 years; range 1 day to 9.3 years). Estimated locoregional recurrence-free survival, distant metastasis-free survival (DMFS), overall survival (OS), and cancer-specific survival (CSS) rates (95% confidence interval [CI] number still at risk) at 5 years after surgery were 92% (88-95; 92), 90% (86-94; 92), 86% (82-92; 98), and 94% (91-97; 98), respectively. Negative margins were achieved in 98% of cases. The adult comorbidity evaluation (ACE)-27 comorbidity index, human papillomavirus (HPV) status, pathologic N classification, and number of attempts to clear margins were associated with death due to cancer (P = .003, P = .002, P = .030, and P = .002, respectively). ConclusionThe need to take 2 margins to achieve resection portends an increased risk of locoregional recurrence and death due to disease in oropharyngeal SCC.