Transoral Robotic Surgery (TORS) Versus Open Surgery for Recurrent Oropharyngeal Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis.

Abstract

Salvage surgery (SS) is one of the best treatment options for recurrent oropharyngeal squamous cell carcinoma (OPSCC) after prior definitive radiation. A Medline literature search of articles on open (OSS) and transoral robotic surgery (TORS) for the treatment of recurrent OPSCC was performed. Surgical, functional, and oncological outcomes were analyzed and compared. A total of 18 studies including 567 (66.2%) patients undergoing OSS and 290 (33.8%) undergoing TORS were included. Patients undergoing TORS vs. OSS had early T- and N-classification tumors, p < 0.01, respectively. OSS patients had higher rates of feeding tube and tracheostomy dependence compared with TORS (p < 0.01). The mean 2-year overall survival in patients undergoing TORS was 68.5% versus 45.9% in the OSS group, p = 0.03. Patients undergoing TORS had smaller tumors and less advanced nodal disease. Furthermore, they developed less postoperative feeding tube and tracheostomy dependency, and had better 2-year overall survival than patients undergoing OSS.