Surgical Approach of Oropharyngeal Squamous Cell Carcinoma (SCC) With Transoral Robotic Surgery Versus Non-robotic Transoral Surgery and Laser: A Systematic Review

Abstract

Oropharyngeal squamous cell carcinoma (OPSCC) is among the most common head and neck cancers, with increasing use of surgical treatment for stage T1/T2 cases. This study compares the oncological outcomes of transoral robotic surgery (TORS) with non-robotic transoral surgery. A systematic review of the Ovid database was conducted using defined inclusion and exclusion criteria. Data extraction was performed independently by two authors, and publication quality was assessed using the Oxford Centre for Evidence-Based Medicine criteria. Outcomes related to oncological margins, swallowing, and voice function were analyzed descriptively. Ten studies met the inclusion criteria, most of which were retrospective cohort studies. The comparative analysis demonstrated that TORS provides better overall oncological outcomes than non-TORS in patients with T1/T2 OPSCC. In addition, TORS was associated with a 30% higher rate of achieving clear surgical margins. While these findings suggest that TORS may be the superior modality for oncological and functional outcomes, the study is limited by the lack of randomized controlled trials and non-randomized treatment assignments. Further prospective randomized trials are necessary to confirm these results and establish clinical practice guidelines.