ArticleThe Laryngoscope2025
Outcomes of HPV+ Oropharyngeal Carcinoma of Unknown Primary Following Transoral Robotic Surgery.
Article in The Laryngoscope, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- The application of transoral robotic surgery in the treatment of head and neck tumors: a bibliometric analysis based on the web of science core collection database.Journal of robotic surgery · 2026Article
- Outcomes of HPV+ Oropharyngeal Carcinoma of Unknown Primary Following Transoral Robotic Surgery.The Laryngoscope · 2025Article
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Authors and funding
19 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTreatment of patients with head and neck squamous cell carcinoma of unknown primary (CUP) is challenging. Given the relative rarity of this condition and the recent use of primary transoral robotic surgery (TORS) in modern diagnostic and treatment algorithms, long-term oncologic outcomes are unclear. The objectives were to evaluate oncologic outcomes of patients treated with TORS for management of CUP.
methodsThis retrospective case series was conducted at a tertiary care academic medical center from 2010 to 2021. All patients with HPV-mediated CUP who underwent TORS-assisted endoscopy were included. CUP was defined as biopsy-proven squamous cell carcinoma in a cervical lymph node with uncertain primary location following standard-of-care clinical and radiologic assessment. Primary outcomes were recurrence-free survival and overall survival. Secondary outcomes included usage of radiation and chemotherapy.
resultsIn total, 157 patients were included in the study. Median follow-up time was 62 months. Primary tumor was identified in 88% of patients. Surgery alone was performed in 21%, although adjuvant therapy was recommended but declined in 13%. Adjuvant radiation was completed in 46% and adjuvant chemoradiation in 33%. Two-thirds of patients avoided chemoradiation. Overall survival was 94% and recurrence-free survival was 92% at 5 years.
conclusionIn the largest reported experience to date of TORS-assisted management of CUP, we demonstrate that this approach facilitates a high rate of identification of occult mucosal malignancies and can eliminate the need for chemotherapy and potentially radiation therapy in select patients without compromising excellent oncologic and functional outcomes. LEVEL OF EVIDENCE: 4:
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