• Gregory S Weinstein, Harry Quon, H Jason Newman, J Ara Chalian, Kelly Malloy, Alexander Lin, Arati Desai, Virginia A Livolsi, Kathleen T Montone, K Roger Cohen, and Bert W O'Malley.
• Department of Otorhinolaryngology–Head and Neck Surgery, University of Pennsylvania Medical Center, Philadelphia, USA. gregory.weinstein@uphs.upenn.edu
• Arch. Otolaryngol. Head Neck Surg. 2012 Jul 1; 138 (7): 628-34.

ObjectiveTo evaluate local control following transoral robotic surgery (TORS) with the da Vinci Surgical System (Intuitive Surgical Inc) as a single treatment modality for oropharyngeal squamous cell carcinoma (OSCC).DesignProspective, single-center, observational study.SettingAcademic university health system and tertiary referral center.PatientsThirty adults with previously untreated OSCC.InterventionTransoral robotic surgery with staged neck dissection as indicated.Main Outcome MeasuresLocal control and margin status.ResultsThirty patients were enrolled with previously untreated OSCC and no prior head and neck radiation therapy. Follow-up duration was at least 18 months. At the time of diagnosis, 9 tumors were T1 (30%); 16 were T2 (53%); 4 were T3 (13%); and 1 was T4a (3%). The anatomic sites of these primary tumors were tonsil in 14 (47%), tongue base in 9 (30%), glossotonsillar sulcus in 3 (10%), soft palate in 3 (10%), and oropharyngeal wall in 1 (3%). There was only 1 patient (3%) who had a positive margin after primary resection; further resection achieved a final negative margin. Perineural invasion was noted in 3 tumors (10%). No patient received postoperative adjuvant therapy. At a mean follow-up of 2.7 years (range, 1.5-5.1 years), there was 1 patient with local failure (3%).ConclusionAs the only modality used for treatment of pathologically low-risk OSCCs, TORS provides high local control and is associated with low surgical morbidity.

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