Trans Oral Robotic Surgery for HPV-Negative Oropharyngeal Squamous Cell Carcinoma: Follow-Up on Oncological and Functional Outcomes

Background: The efficacy of transoral robotic surgery (TORS) for HPV-negative oropharyngeal cancers (OPSCC) is less explored, especially regarding long-term outcomes and prognostic factors.

Methods: We conducted a retrospective monocentric study on 37 patients with HPV-negative OPSCC treated with TORS with a median follow-up of 3 years, assessing survival outcomes using Kaplan-Meyer statistics and swallowing function via the functional outcome swallowing scale (FOSS). Histopathological parameters were collected either from medical records or histology slides were re-evaluated.

Results: Patients demonstrated high disease-specific survival (DSS) but lower overall survival (OS), with a cohort characterized by high comorbidity rates. Vascular invasion was a significant adverse factor for relapse-free survival (RFS) and OS, while lymphatic invasion was not. Most patients demonstrated significant preservation of swallowing function.

Conclusions: TORS for HPV-negative OPSCC demonstrates high DSS and preserved swallowing function. Vascular invasion is a key prognostic factor for survival outcomes.