Transoral Robotic Surgery ( <scp>TORS</scp> ) Versus Open Surgery for Recurrent Oropharyngeal Squamous Cell Carcinoma: A Systematic Review and Meta‐Analysis

Abstract

BACKGROUND: Salvage surgery (SS) is one of the best treatment options for recurrent oropharyngeal squamous cell carcinoma (OPSCC) after prior definitive radiation. METHODS: 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. RESULTS: 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. CONCLUSION: 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.