Journal of Clinical Medicine · 5 authors, 2 centres
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This narrative review evaluates transoral robotic surgery (TORS) for head and neck cancer by synthesizing evidence from retrospective cohorts, systematic reviews, and one randomized phase II trial. The central finding is that TORS offers comparable oncological outcomes to conventional treatments for selected early-stage tumors, though high-level comparative evidence remains limited.
This narrative review examines the current evidence base for transoral robotic surgery (TORS) across oropharyngeal, laryngeal, and hypopharyngeal cancers. The review synthesizes findings from retrospective cohorts, systematic reviews, and the phase II ORATOR randomized trial. For oropharyngeal cancer, a multicentric cohort of 410 patients treated with TORS reported 3-year overall survival of 87.1% and disease-specific survival of 94.5%. The ORATOR trial found comparable toxicity profiles between TORS and definitive (C)RT, though swallowing-related quality of life was better in the (C)RT arm at 1 year. For supraglottic laryngeal cancer, a systematic review of 422 patients showed 2-year local control exceeding 94.3%. The review identifies key knowledge gaps: the lack of randomized controlled trials comparing TORS to open surgery, limited long-term functional outcome data, inconsistent base-of-tongue mucosectomy recommendations for carcinomas of unknown primary, and the need for TORS-specific instruments. Implications suggest that technical advances in robotic platforms may expand indications, but evidence-based expansion should remain cautious.
