Treatment De-escalation in Oropharyngeal Carcinoma and the Role of Robotic Surgery

John Ceremsak; Wenda Ye; Melanie Hicks; Kyle Mannion

doi:10.1016/j.soc.2024.07.001

Treatment De-escalation in Oropharyngeal Carcinoma and the Role of Robotic Surgery

Surg Oncol Clin N Am. 2024 Oct;33(4):697-709. doi: 10.1016/j.soc.2024.07.001. Epub 2024 Aug 1.

Authors

John Ceremsak¹, Wenda Ye², Melanie Hicks², Kyle Mannion²

Affiliations

¹ Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, 1215 Medical Center Drive, Nashville, TN 27232, USA. Electronic address: [email protected].
² Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, 1215 Medical Center Drive, Nashville, TN 27232, USA.

PMID: 39244288
DOI: 10.1016/j.soc.2024.07.001

Abstract

Oropharyngeal squamous cell carcinoma (OPSCC) related to human papillomavirus (HPV) infection has better survival outcomes compared to non-HPV-related OPSCC, leading to efforts to de-escalate the intensity of treatment to reduce associated morbidity. This article reviews recent clinical efforts to explore different de-escalation frameworks with a particular emphasis on the emergence of transoral robotic surgery and surgically driven de-escalation approaches. It discusses the current evidence for incorporating surgery into an evolving treatment paradigm for HPV-related OPSCC.

Keywords: De-escalation; HPV; Oropharynx; SCC; TORS.

Publication types

Review

MeSH terms

Carcinoma, Squamous Cell / pathology
Carcinoma, Squamous Cell / surgery
Carcinoma, Squamous Cell / virology
Humans
Oropharyngeal Neoplasms* / surgery
Oropharyngeal Neoplasms* / virology
Papillomavirus Infections* / complications
Papillomavirus Infections* / surgery
Robotic Surgical Procedures* / methods