• Giuseppe Meccariello, Andrea Catalano, Giovanni Cammaroto, Giannicola Iannella, Claudio Vicini, Sheng-Po Hao, and Andrea De Vito.
• Otolaryngology and Head-Neck Surgery Unit, Department of Head-Neck Surgeries, Morgagni Pierantoni Hospital, Health Local Agency Romagna, 47121 Forlì, Italy.
• Medicina (Kaunas). 2022 Aug 4; 58 (8).

Objectiveto show an overview on the treatments' options for stage I and II oropharyngeal carcinomasquamous cell carcinoma (OPSCC).BackgroundThe traditional primary treatment modality of OPSCC at early stages is intensity modulated radiation therapy (IMRT). Trans-oral robotic surgery (TORS) has offered as an alternative, less invasive surgical option. Patients with human papilloma virus (HPV)-positive OPSCC have distinct staging with better overall survival in comparison with HPV-negative OPSCC patients.Methodsa comprehensive review of the English language literature was performed using PubMed, EMBASE, the Cochrane Library, and CENTRAL electronic databases.ConclusionsMany trials started examining the role of TORS in de-escalating treatment to optimize functional consequences while maintaining oncologic outcome. The head-neck surgeon has to know the current role of TORS in HPV-positive and negative OPSCC and the ongoing trials that will influence its future implementation. The feasibility of this treatment, the outcomes ensured, and the side effects are key factors to consider for each patient. The variables reported in this narrative review are pieces of a bigger puzzle called tailored, evidence-based driven medicine. Future evidence will help in the construction of robust and adaptive algorithms in order to ensure the adequate treatment for the OPSCC at early stages.

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