%0 Journal Article
%T The Role of Transoral Robotic Surgery in the Management of Oropharyngeal Cancer: A Review of the Literature
%A Samuel A. Dowthwaite
%A Jason H. Franklin
%A David A. Palma
%A Kevin Fung
%A John Yoo
%A Anthony C. Nichols
%J ISRN Oncology
%D 2012
%R 10.5402/2012/945162
%X Background. Transoral robotic surgery (TORS) is an emerging treatment option for the treatment of head and neck malignancies, particularly for oropharyngeal squamous cell carcinoma (OPSCC). Preliminary studies have demonstrated excellent oncologic and functional outcomes that have led to a resurgence of interest in the primary surgical management of OPSCC. The aim of the present study was to review the evidence base supporting the use of TORS in OPSCC. Methods. Studies evaluating the application of TORS in the treatment of head and neck squamous cell carcinoma (HNSCC), and more specifically OPSCC, were identified for review. Further searches were made of reference lists for complete evaluation of minimally invasive surgery (MIS) in treating OPSCC. Results. Seventeen results relating to the application of TORS in treatment of OPSCC were identified. Further results relating to the role of transoral laser microsurgery (TLM) in OPSCC were included for review. Feasibility, oncologic, and functional data is summarized and discussed. Discussion. Management strategies for patients with OPSCC continue to evolve. Minimally invasive surgical techniques including TORS and TLM offer impressive functional and oncologic outcomes particularly for patients with early T-classification and low-volume regional metastatic disease. Potential exists for treatment deintensification, particularly in patients who are HPV positive. 1. Introduction Approximately 500,000 new cases of head and neck squamous cell carcinoma (HNSCC) are diagnosed each year making HNSCC the 6th most common cancer worldwide [1]. The rate of HNSCC has been increasing recently secondary to an epidemic of human papillomavirus- (HPV-) related oropharyngeal squamous cell cancer (OPSCC). These trends, which have seen rates of OPSCC as much as double over the last three decades in some countries, have been associated with a shift in demographics to a younger population that is typically high functioning with lower rates of comorbid illness [2]. Combined with lower rates of smoking and alcohol abuse and an intrinsic improved response rate of HPV-related OPSCC to curative treatment regimens, the overall and disease-free survival rates in this patient group are significantly higher than previously observed. As such, long-term quality of life considerations have been made even more relevant to the multidisciplinary team coordinating the care of these patients. These new developments in the pathogenesis of HNSCC, and in particular OPSCC, are occurring in the context of large-scale paradigm shifts over the past two
%U http://www.hindawi.com/journals/isrn.oncology/2012/945162/