Transoral robotic surgery and human papillomavirus status: Oncologic results

Authors

  • Marc A. Cohen MD,

    1. Department of Otorhinolaryngology–Head and Neck Surgery, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
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    • Marc A. Cohen, Gregory S. Weinstein, Harry Quon, and Bert W. O'Malley Jr are co-first authors.

  • Gregory S. Weinstein MD,

    Corresponding author
    1. Department of Otorhinolaryngology–Head and Neck Surgery, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
    • Department of Otorhinolaryngology – Head and Neck Surgery, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
    Search for more papers by this author
    • Marc A. Cohen, Gregory S. Weinstein, Harry Quon, and Bert W. O'Malley Jr are co-first authors.

  • Bert W. O'Malley Jr MD,

    1. Department of Otorhinolaryngology–Head and Neck Surgery, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
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    • Marc A. Cohen, Gregory S. Weinstein, Harry Quon, and Bert W. O'Malley Jr are co-first authors.

  • Michael Feldman MD,

    1. Department of Pathology, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
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  • Harry Quon MD

    1. Department of Otorhinolaryngology–Head and Neck Surgery, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
    2. Department of Radiation Oncology, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
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    • Marc A. Cohen, Gregory S. Weinstein, Harry Quon, and Bert W. O'Malley Jr are co-first authors.


  • Gregory S. Weinstein and Bert W. O'Malley, Jr. are consultants for Intuitive Surgical, Inc.

Abstract

Background

Patients with oropharyngeal squamous cell carcinoma (OPSCC) have been shown to have distinct outcome profiles based on their human papillomavirus (HPV) status. The purpose of this study was to assess HPV-related outcomes after transoral robotic surgery (TORS) with adjuvant therapy as indicated.

Methods

This study consisted of a retrospective review of 50 patients with OPSCC within a prospective single-arm cohort study. Outcome measures included HPV status, margin status, relapse pattern, and survival.

Results

Thirty-seven patients were HPV-positive (74.0%) with 34 patients (91.9%) being serotype-16. Negative margins were achieved in 92.3% (HPV-negative) and 94.6% (HPV-positive). In the HPV-negative group, there were no local recurrences and 1 patient had both regional and distant recurrence (7.7%). In the HPV-positive group, there were no local or regional recurrences and 2 patients (5.4%) had distant recurrences. There were no statistically significant differences in survival between the 2 cohorts (overall survival, disease-specific survival, disease-free survival).

Conclusion

TORS as a primary surgical modality, followed by adjuvant therapy as indicated, offers disease control in both HPV-negative and HPV-positive groups. We believe that multi-institutional studies are warranted to further evaluate this novel approach for patients who are HPV negative and HPV positive. © 2010 Wiley Periodicals, Inc. Head Neck, 2011

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