Introduction: International guidelines include transoral robotic surgery (TORS) as an option for selected oropharyngeal squamous cell carcinomas (OPSCCs). In the perspective of treatment de-intensification, many surgeons have started recommending and performing TORS preferentially in p16- positive OPSCC in order to reduce the long-term morbidity related to chemoradiotherapy. The aim of the present review is to analyze the current evidence supporting the above-cited strategy. Materials and Methods: The study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Twenty-two studies were included in this review, with a total of 3992 patients treated with primary TORS. The majority of patients were classified as HPV+ (n = 3655, 91.6%), and 8.2% (n = 327) as HPV−. The HPV status was unknown in only 10 (0.3%) patients. In particular, only five of the included studies compared survival outcomes of HPV−positive patients with HPV−negative ones treated with primary TORS, and only two of these found a significant improvement in survival in the HPV−driven cohort. Discussion: The current literature does not clarify whether HPV+ OPSCCs treated with TORS, alone or with adjuvant treatments, are associated with a better oncologic and/or functional outcome compared to those treated with radio- or chemoradiotherapy. However, TORS alone obtained good oncological outcomes in a high percentage of cases in the reviewed series. Recent data, on the other hand, suggest that TORS could represent a promising strategy for intensifying treatments in HPV− OPSCC.

Do We Have Enough Evidence to Specifically Recommend Transoral Robotic Surgery in HPV−Driven Oropharyngeal Cancer? A Systematic Review / De Virgilio, A.; Costantino, A.; Rizzo, D.; Crescio, C.; Gallus, R.; Spriano, G.; Mercante, G.; Festa, B. M.; Accorona, R.; Pignataro, L.; Capaccio, P.; Bussu, F.. - In: PATHOGENS. - ISSN 2076-0817. - 12:2(2023), p. 160. [10.3390/pathogens12020160]

Do We Have Enough Evidence to Specifically Recommend Transoral Robotic Surgery in HPV−Driven Oropharyngeal Cancer? A Systematic Review

Rizzo D.;Crescio C.;Bussu F.
2023-01-01

Abstract

Introduction: International guidelines include transoral robotic surgery (TORS) as an option for selected oropharyngeal squamous cell carcinomas (OPSCCs). In the perspective of treatment de-intensification, many surgeons have started recommending and performing TORS preferentially in p16- positive OPSCC in order to reduce the long-term morbidity related to chemoradiotherapy. The aim of the present review is to analyze the current evidence supporting the above-cited strategy. Materials and Methods: The study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Twenty-two studies were included in this review, with a total of 3992 patients treated with primary TORS. The majority of patients were classified as HPV+ (n = 3655, 91.6%), and 8.2% (n = 327) as HPV−. The HPV status was unknown in only 10 (0.3%) patients. In particular, only five of the included studies compared survival outcomes of HPV−positive patients with HPV−negative ones treated with primary TORS, and only two of these found a significant improvement in survival in the HPV−driven cohort. Discussion: The current literature does not clarify whether HPV+ OPSCCs treated with TORS, alone or with adjuvant treatments, are associated with a better oncologic and/or functional outcome compared to those treated with radio- or chemoradiotherapy. However, TORS alone obtained good oncological outcomes in a high percentage of cases in the reviewed series. Recent data, on the other hand, suggest that TORS could represent a promising strategy for intensifying treatments in HPV− OPSCC.
2023
Do We Have Enough Evidence to Specifically Recommend Transoral Robotic Surgery in HPV−Driven Oropharyngeal Cancer? A Systematic Review / De Virgilio, A.; Costantino, A.; Rizzo, D.; Crescio, C.; Gallus, R.; Spriano, G.; Mercante, G.; Festa, B. M.; Accorona, R.; Pignataro, L.; Capaccio, P.; Bussu, F.. - In: PATHOGENS. - ISSN 2076-0817. - 12:2(2023), p. 160. [10.3390/pathogens12020160]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11388/306850
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