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Transoral Robotic Surgery Ups Survival in Oropharyngeal Cancer

Outcomes and survival improved for early-stage oropharyngeal cancer, but not other cancers

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MONDAY, Aug. 24, 2020 (HealthDay News) -- For patients with early-stage oropharyngeal cancer, transoral robotic surgery is associated with improved surgical outcomes and survival, according to a study published online Aug. 20 in JAMA Oncology.

Anthony T. Nguyen, M.D., Ph.D., from the Cedars-Sinai Medical Center in Los Angeles, and colleagues compared long-term outcomes of transoral robotic surgery to those of nonrobotic surgery for patients with early-stage oropharyngeal cancer in a retrospective cohort comparative effectiveness analysis. Data were included for 9,745 patients, of whom 27.6 percent underwent transoral robotic surgery.

The researchers found that from 2010 through 2015, use of robotic surgery increased significantly from 18.3 to 35.5 percent of all surgical procedures for T1 and T2 oropharyngeal cancers. There was an association seen for robotic surgery with reduced rates of positive surgical margins (12.5 versus 20.3 percent) and lower adjuvant chemoradiotherapy use (28.6 versus 35.7 percent). Compared with nonrobotic surgery, robotic surgery correlated with improved overall survival among 4,071 patients with known human papillomavirus status (hazard ratio, 0.74). In propensity score-matched cohorts, the five-year overall survival was 84.8 and 80.3 percent among patients undergoing robotic versus nonrobotic surgery. In contrast, no evidence was seen for robotic surgery improving survival in other cancers such as prostate, endometrial, or cervical cancer.

"These results are hypothesis generating," the authors write. "The association between robotic surgery and improved survival was unique to oropharyngeal squamous cell carcinoma, and was not observed in prostate, endometrial, or cervical cancers."

One author disclosed financial ties to biopharmaceutical companies.

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