Feasibility of ensuring surgical margins of transoral robotic surgery for lateral oropharyngectomy for p16-positive oropharyngeal squamous cell carcinoma patients compared with non-robotic surgery: A single-center, retrospective study

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OBJECTIVE: This study aimed to elucidate the utility of transoral robotic surgery (TORS) for lateral oropharyngectomy in patients with HPV-associated oropharyngeal squamous cell carcinoma (OPSCC) by comparing its treatment outcomes with those of conventional non-robotic procedures. METHODS: The clinical charts of patients with newly diagnosed p16-positive OPSCC from the lateral wall who underwent lateral oropharyngectomy at our institution between 2016 and 2025 were retrospectively reviewed. The patients were divided into two groups according to the surgical approach: the non-robotic procedure group, treated via direct visualization or transoral videolaryngoscopic surgery, and the TORS group, treated using the da Vinci Surgical System. Clinicopathological data were compared between the groups. RESULTS: This study included 105 patients, 80 of whom underwent non-robotic procedures, and 25 underwent TORS. The TORS group exhibited a significantly lower rate of positive surgical margins (36% vs. 4%, P < .001). Logistic regression analysis revealed that TORS is an independent predictor of negative margins (odds ratio, 0.15; 95% confidence interval, 0.03-0.70; P = .02). CONCLUSIONS: TORS was associated with superior margin control, supporting its utility as a primary treatment modality for p16-positive OPSCC.

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