Role of Transoral Robotic Surgery in Treatment of Oropharyngeal Carcinoma

Abstract Background Transoral surgery in the oropharynx is a surgical strategy for directly accessing and resecting oropharyngeal tumors through the mouth. Direct access to the tumor, as opposed to transcervical approaches, helps avoid the morbidity of open approaches and thus allows for faster recovery of the functions, the most important of which is swallowing. Aim of the Work The aim of this work is to provide cumulative data about the efficacy and safety of transoral robotic surgery (TORS) and long term oncologic and the functional outcomes of TORS in treatment of oropharyngeal carcinoma by doing a meta-analytical study. Materials and Methods This review was done using standard methodology outlined in the Cochrane Handbook and reported the findings in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement guidelines. This meta-analysis was conducted to provide cumulative data about the efficacy and safety of transoral robotic surgery (TORS), and long-term oncologic and functional outcomes of TORS in the treatment of oropharyngeal carcinoma. We enrolled 12 studies that studied the outcome of TORS surgeries of oropharyngeal carcinoma patients. These studies contained 4460 patients with 3688 male patients and 772 female patients with a male-to-female ratio of 5.1/1. Results Our meta-analysis showed that the pooled (disease free survival rate) in random effect model was 86.2% and in random effect model pooled (overall survival rate) was 90.3%. Our meta-analysis showed that in oropharyngeal carcinoma patients in random-effects models the pooled (local recurrence rate) was 2.6%, for regional recurrence rate was 3.5% and for distant recurrence rate was 3.2%. Conclusion These findings showed that TORS had a better locoregional control rate than different treatment modalities. this difference was due to differences in tumor stage and site in different studies and used techniques. Regarding the prolonged gastrostomy tube dependence rate, this meta-analysis showed that the rate was 6.1% in the random-effects model.