Skip to main content
Top
Published in: Indian Journal of Otolaryngology and Head & Neck Surgery 4/2022

09-09-2022 | Neck Dissection | Original Article

Analysis of Outcomes following TORS in a Mixed Cohort of Recurrent and New T1-T2 Oropharyngeal Cancer- A Single Institution Study

Authors: Naresh K Panda, Archit Kapoor, Nitika Goel, Sushmita Ghoshal, Varinder Singh, Amanjit Bal

Published in: Indian Journal of Otolaryngology and Head & Neck Surgery | Issue 4/2022

Login to get access

Abstract

Purpose

. The transoral robotic surgery is a newer modality being used in surgical treatment of early oropharyngeal cancer. The aim of this study is to assess the outcome of these cases in terms of two year disease free survival and overall survival.

Methods

Between July 2016 and September 2018, 58 patients suffering from early oropharyngeal cancer underwent transoral robotic surgery with neck dissection at a tertiary referral centre. 43 of them have completed two years follow up and were analyzed for disease free survival and overall survival. 41 patients had HPV analysis done .

Results

The surgical margins were positive in 9/43 patients ( 6 in upfront surgery and 3 in the salvage cohort). Adjuvant therapy was administered to 16/34 patients on account of either positive margins or multiple nodal metastasis. 88% patients were found to be HPV negative. The two year disease free survival for the upfront cohort was 88.2% and salvage cohort was 55.5%. The overall survival was 86.05%.

Conclusions

The study highlights good locoregional control and two year disease free survival in HPV negative oropharyngeal cancer undergoing robotic surgery. Additionally, a positive surgical margin and recurrence were the statistically significant variables influencing 2 year disease free survival. Trans oral robotic surgery is an excellent tool for early tumors of the oropharynx. The presence of a positive surgical margin is a grim sign for survival and has a significant impact on positive outcome.
Appendix
Available only for authorised users
Literature
1.
go back to reference Weinstein GS, O’Malley BW, Cohen MA, Quon H (2010) Transoral robotic surgery for advanced oropharyngeal carcinoma. Arch Otolaryngol –Head & Neck Surg. 136;1079-85 Weinstein GS, O’Malley BW, Cohen MA, Quon H (2010) Transoral robotic surgery for advanced oropharyngeal carcinoma. Arch Otolaryngol –Head & Neck Surg. 136;1079-85
2.
go back to reference US Food and DrugAdministration.501(k) Summary: Indications for Use for Intuitive SurgicaEndoscopic Instrument Control System for Transoral Otolaryngology Procedures. Silver Spring, MD: US Food and Drug Administration; US Food and DrugAdministration.501(k) Summary: Indications for Use for Intuitive SurgicaEndoscopic Instrument Control System for Transoral Otolaryngology Procedures. Silver Spring, MD: US Food and Drug Administration;
3.
go back to reference Weinstein GS, O’Malley BW Jr, Magnuson JS, Carroll WR, Olsen KD, Daio L et al (2012) Transoral robotic surgery: a multicenter study to assess feasibility, safety, and surgical margins. The Laryngoscope. 122;1701-7 Weinstein GS, O’Malley BW Jr, Magnuson JS, Carroll WR, Olsen KD, Daio L et al (2012) Transoral robotic surgery: a multicenter study to assess feasibility, safety, and surgical margins. The Laryngoscope. 122;1701-7
4.
go back to reference Parsons JT, Mendenhall WM, Stringer SP, Amdur RJ, Hinerman RW, Villaret DB et al (2002) Squamous cell carcinoma of the oropharynx: surgery, radiation therapy, or both. Cancer 94:2967–2980CrossRef Parsons JT, Mendenhall WM, Stringer SP, Amdur RJ, Hinerman RW, Villaret DB et al (2002) Squamous cell carcinoma of the oropharynx: surgery, radiation therapy, or both. Cancer 94:2967–2980CrossRef
5.
go back to reference Ang KK, Harris J, Wheeler R, Weber R, Rosenthal DI, Nguyen-Tân PF, Westra WH, Chung CH, Jordan RC, Lu C, Kim H (2010) Human papilloma virus and survival of patients with oropharyngeal cancer. N Engl J Med. 363;24–35 Ang KK, Harris J, Wheeler R, Weber R, Rosenthal DI, Nguyen-Tân PF, Westra WH, Chung CH, Jordan RC, Lu C, Kim H (2010) Human papilloma virus and survival of patients with oropharyngeal cancer. N Engl J Med. 363;24–35
6.
go back to reference Rahmati R, Dogan S, Pyke O, Palmer F, Awad M, Lee N, Kraus DH, Shah JP, Patel SG, Ganly I (2015) Squamous cell carcinoma of the tonsil managed by conventional surgery and postoperative radiation. Head and Neck 37:800–807CrossRef Rahmati R, Dogan S, Pyke O, Palmer F, Awad M, Lee N, Kraus DH, Shah JP, Patel SG, Ganly I (2015) Squamous cell carcinoma of the tonsil managed by conventional surgery and postoperative radiation. Head and Neck 37:800–807CrossRef
7.
go back to reference Lamarre ED, Seth R, Lorenz RR, Esclamado R, Adelstein DJ, Rodriguez CP, Saxton J, Scharpf J (2012) Intended single-modality management of T1 and T2 tonsillar carcinomas: retrospective comparison of radical tonsillectomy vs radiation from a single institution. Am J Otolaryngol 33:98–103CrossRef Lamarre ED, Seth R, Lorenz RR, Esclamado R, Adelstein DJ, Rodriguez CP, Saxton J, Scharpf J (2012) Intended single-modality management of T1 and T2 tonsillar carcinomas: retrospective comparison of radical tonsillectomy vs radiation from a single institution. Am J Otolaryngol 33:98–103CrossRef
8.
go back to reference Moncrieff M, Sandilla J, Clark J, Clifford A, Shannon K, Gao K, O’Brien C (2009) Outcomes of primary surgical treatment of T1 and T2 carcinomas of the oropharynx.The Laryngoscope. 119;307 – 11 Moncrieff M, Sandilla J, Clark J, Clifford A, Shannon K, Gao K, O’Brien C (2009) Outcomes of primary surgical treatment of T1 and T2 carcinomas of the oropharynx.The Laryngoscope. 119;307 – 11
9.
go back to reference Cosmidis A, Rame JP, Dassonville O, Temam S, Massip F, Poissonnet G, Poupart M, Marandas P, De Raucourt D (2004) T1-T2 NO oropharyngeal cancers treated with surgery alone. A GETTEC study. European Archives of Oto-Rhino-Laryngology and Head & Neck. 261;276 – 81 Cosmidis A, Rame JP, Dassonville O, Temam S, Massip F, Poissonnet G, Poupart M, Marandas P, De Raucourt D (2004) T1-T2 NO oropharyngeal cancers treated with surgery alone. A GETTEC study. European Archives of Oto-Rhino-Laryngology and Head & Neck. 261;276 – 81
11.
go back to reference Mendenhall WM, Morris CG, Amdur RJ, Hinerman RW, Malyapa RS, Werning JW, Lansford CD, Villaret DB (2006) Definitive radiotherapy for tonsillar squamous cell carcinoma. Am J Clin Oncol 29:290–297CrossRef Mendenhall WM, Morris CG, Amdur RJ, Hinerman RW, Malyapa RS, Werning JW, Lansford CD, Villaret DB (2006) Definitive radiotherapy for tonsillar squamous cell carcinoma. Am J Clin Oncol 29:290–297CrossRef
12.
go back to reference Mendenhall WM, Morris CG, Amdur RJ, Hinerman RW, Werning JW, Villaret DB (2006) Definitive radiotherapy for squamous cell carcinoma of the base of tongue.Am J Clin Oncol.29;32 – 9 Mendenhall WM, Morris CG, Amdur RJ, Hinerman RW, Werning JW, Villaret DB (2006) Definitive radiotherapy for squamous cell carcinoma of the base of tongue.Am J Clin Oncol.29;32 – 9
13.
go back to reference Selek U, Garden AS, Morrison WH, El-Naggar AK, Rosenthal DI, Ang KK (2004) Radiation therapy for early-stage carcinoma of the oropharynx.Int. J Rad Oncol Biol* Phys.59;743 – 51 Selek U, Garden AS, Morrison WH, El-Naggar AK, Rosenthal DI, Ang KK (2004) Radiation therapy for early-stage carcinoma of the oropharynx.Int. J Rad Oncol Biol* Phys.59;743 – 51
14.
go back to reference Ukpo OC, Pritchett CV, Lewis JE, Weaver AL, Smith DI, Moore EJ (2009) Human Papilloma virus—Associated Oropharyngeal Squamous Cell Carcinomas: Primary Tumor Burden and Survival in Surgical Patients. Annals of Otology, Rhinology and Laryngology. 118;368 – 73 Ukpo OC, Pritchett CV, Lewis JE, Weaver AL, Smith DI, Moore EJ (2009) Human Papilloma virus—Associated Oropharyngeal Squamous Cell Carcinomas: Primary Tumor Burden and Survival in Surgical Patients. Annals of Otology, Rhinology and Laryngology. 118;368 – 73
15.
go back to reference Dahlstrom KR, Calzada G, Hanby JD, Garden AS, Glisson BS, Li G, Roberts DB, Weber RS, Sturgis EM (2013) An evolution in demographics, treatment, and outcomes of oropharyngeal cancer at a major cancer center: a staging system in need of repair. Cancer. 119;81 – 9 Dahlstrom KR, Calzada G, Hanby JD, Garden AS, Glisson BS, Li G, Roberts DB, Weber RS, Sturgis EM (2013) An evolution in demographics, treatment, and outcomes of oropharyngeal cancer at a major cancer center: a staging system in need of repair. Cancer. 119;81 – 9
16.
go back to reference Pytynia KB, Dahlstrom KR, Sturgis EM (2014) Epidemiology of HPV-associated oropharyngeal cancer. Oral Oncol.50;380-6 Pytynia KB, Dahlstrom KR, Sturgis EM (2014) Epidemiology of HPV-associated oropharyngeal cancer. Oral Oncol.50;380-6
17.
go back to reference Chaturvedi AK, Engels EA, Pfeiffer RM, Hernandez BY, XiaoW, Kim E et al (2011) Human Papilloma virus and rising oropharyngeal cancer incidence in the United States. J Clin Oncol 29:4294–4301CrossRef Chaturvedi AK, Engels EA, Pfeiffer RM, Hernandez BY, XiaoW, Kim E et al (2011) Human Papilloma virus and rising oropharyngeal cancer incidence in the United States. J Clin Oncol 29:4294–4301CrossRef
18.
go back to reference Bahl A, Kumar P, Dar L, Mohanti BK, Sharma A, Thakar A, Karthikeyan V, Sikka K, Singh C, Poo K, Lodha J (2014) Prevalence and trends of human papillomavirus in oropharyngeal cancer in a predominantly north Indian population.Head Neck. 36;505 – 10 Bahl A, Kumar P, Dar L, Mohanti BK, Sharma A, Thakar A, Karthikeyan V, Sikka K, Singh C, Poo K, Lodha J (2014) Prevalence and trends of human papillomavirus in oropharyngeal cancer in a predominantly north Indian population.Head Neck. 36;505 – 10
19.
go back to reference Murthy V, Swain M, Teni T, Pawar S, Kalkar P, Patil A, Chande A, Ghonge S, Laskar SG, Gupta T, Budrukkar A (2016) Human papilloma virus/p16 positive head and neck cancer in India: Prevalence, clinical impact, and influence of tobacco use. Indian J of Cancer 53:387–393 Murthy V, Swain M, Teni T, Pawar S, Kalkar P, Patil A, Chande A, Ghonge S, Laskar SG, Gupta T, Budrukkar A (2016) Human papilloma virus/p16 positive head and neck cancer in India: Prevalence, clinical impact, and influence of tobacco use. Indian J of Cancer 53:387–393
20.
go back to reference Sannigrahi MK, Singh V, Sharma R, Panda NK, Radotra BD, Khullar M (2016) Detection of active human papilloma virus-16 in head and neck cancers of Asian North Indian patients.Oral Dis.22;62 – 8 Sannigrahi MK, Singh V, Sharma R, Panda NK, Radotra BD, Khullar M (2016) Detection of active human papilloma virus-16 in head and neck cancers of Asian North Indian patients.Oral Dis.22;62 – 8
21.
go back to reference Thakar A, Panda S, KakkarA, Singh V, Singh CA, Sharma A, Bhasker S, Krishnamurthy P Sharma SC. A matched pair analysis of oncological outcomes in Human papilloma virus negative orpharyngeal squamaous cell carcinoma: Tranoral surgery Vs radiotherapy or concurrent radiation Thakar A, Panda S, KakkarA, Singh V, Singh CA, Sharma A, Bhasker S, Krishnamurthy P Sharma SC. A matched pair analysis of oncological outcomes in Human papilloma virus negative orpharyngeal squamaous cell carcinoma: Tranoral surgery Vs radiotherapy or concurrent radiation
22.
go back to reference Wilson JA, Carding PN, Patterson JM (2011) Dysphagia after nonsurgical head and neck cancer treatment: patients’ perspectives.Otolaryngology–Head and Neck Surgery. 145;767 – 71 Wilson JA, Carding PN, Patterson JM (2011) Dysphagia after nonsurgical head and neck cancer treatment: patients’ perspectives.Otolaryngology–Head and Neck Surgery. 145;767 – 71
23.
go back to reference Patel MM, Pandya AN (2004) Relationship of oral cancer with age, sex, site distribution and habits. Indian J Pathol Microbiol 47:195–197 Patel MM, Pandya AN (2004) Relationship of oral cancer with age, sex, site distribution and habits. Indian J Pathol Microbiol 47:195–197
24.
go back to reference Rosenquist K (2005) Risk factors in oral and oropharyngeal squamous cell carcinoma: a population-based case-control study in southern Sweden. Swed Dent J Suppl 179:1–66 Rosenquist K (2005) Risk factors in oral and oropharyngeal squamous cell carcinoma: a population-based case-control study in southern Sweden. Swed Dent J Suppl 179:1–66
25.
go back to reference Stepnick D, Gilpin D (2010) Head and neck cancer: an overview. In Seminars in plastic surgery. Thieme Med Publishers 24(2):107 Stepnick D, Gilpin D (2010) Head and neck cancer: an overview. In Seminars in plastic surgery. Thieme Med Publishers 24(2):107
26.
go back to reference Weinstein GS, O’Malley BW, Snyder W, Sherman E, Quon H (2007) Transoral robotic surgery: radical tonsillectomy. Arch otolaryngol–Head & Neck Surg 133:1220–1226CrossRef Weinstein GS, O’Malley BW, Snyder W, Sherman E, Quon H (2007) Transoral robotic surgery: radical tonsillectomy. Arch otolaryngol–Head & Neck Surg 133:1220–1226CrossRef
27.
go back to reference Moore EJ, Olsen SM, Laborde RR, Garcia JJ, Walsh FJ, Price DL et al (2012) Long term functional and oncologic results of transoral robotic surgery for oropharyngeal squamous cell carcinoma. Mayo Clin Proc. 87; 219–225 Moore EJ, Olsen SM, Laborde RR, Garcia JJ, Walsh FJ, Price DL et al (2012) Long term functional and oncologic results of transoral robotic surgery for oropharyngeal squamous cell carcinoma. Mayo Clin Proc. 87; 219–225
28.
go back to reference Van Loon JWL, Smeele LE, Hilgers FJM, Van den Brekel MWM (2015) Outcome of transoral robotic surgery for stageI-II oropharyngeal cancer.European Archives of Otorhinolaryngology.272; 175 – 83 Van Loon JWL, Smeele LE, Hilgers FJM, Van den Brekel MWM (2015) Outcome of transoral robotic surgery for stageI-II oropharyngeal cancer.European Archives of Otorhinolaryngology.272; 175 – 83
29.
go back to reference Paleri V, Fox H, Coward S, Ragbir M, McQueen A, Ahmed A et al (2018) Transoral robotic surgery for residual and recurrent oropharyngeal cancers: Exploratory study of surgical innovation using the IDEAL framework for early-phase surgical studies. Head Neck 40:512–525)CrossRef Paleri V, Fox H, Coward S, Ragbir M, McQueen A, Ahmed A et al (2018) Transoral robotic surgery for residual and recurrent oropharyngeal cancers: Exploratory study of surgical innovation using the IDEAL framework for early-phase surgical studies. Head Neck 40:512–525)CrossRef
30.
go back to reference Dabas S, Dewan A, Ranjan R, Dewan AK, Shukla H, Sinha R (2015) Salvage transoral robotic surgery for recurrent or residual Head and Neck squamous cell carcinoma.: A single Institution experience. Asian Pac Cancer Prev 16:7627–7632CrossRef Dabas S, Dewan A, Ranjan R, Dewan AK, Shukla H, Sinha R (2015) Salvage transoral robotic surgery for recurrent or residual Head and Neck squamous cell carcinoma.: A single Institution experience. Asian Pac Cancer Prev 16:7627–7632CrossRef
31.
go back to reference Lewis JS Jr, Beadle B, Bishop JA, Chernock RD, Colasacco C, LacchettiC et al (2018) Human papilloma virus testing in Head and Neck carcinomas. Guidelines from the College of American Pathologists Arch Pathol Lab Med 142:559–597CrossRef Lewis JS Jr, Beadle B, Bishop JA, Chernock RD, Colasacco C, LacchettiC et al (2018) Human papilloma virus testing in Head and Neck carcinomas. Guidelines from the College of American Pathologists Arch Pathol Lab Med 142:559–597CrossRef
32.
go back to reference Ralli M, Singh S, Yadav SP, Sharma N, Verma R, Sen R (2016) Assessment and clinicopathological correlation of p16 expression in head and neck squamous cell carcinoma. J Cancer Res Ther 12:232–237CrossRef Ralli M, Singh S, Yadav SP, Sharma N, Verma R, Sen R (2016) Assessment and clinicopathological correlation of p16 expression in head and neck squamous cell carcinoma. J Cancer Res Ther 12:232–237CrossRef
33.
go back to reference Singh AK, Kushwaha JK, Anand A, Sonkar AA, Husain N, Srivastava K, Singh S (2016) Human Papilloma Virus in Oral Cavity Cancer and Relation to Change in Quality of Life Following Treatment—a Pilot Study from Northern India.Indian J Surg Oncol. 7;386 – 91 Singh AK, Kushwaha JK, Anand A, Sonkar AA, Husain N, Srivastava K, Singh S (2016) Human Papilloma Virus in Oral Cavity Cancer and Relation to Change in Quality of Life Following Treatment—a Pilot Study from Northern India.Indian J Surg Oncol. 7;386 – 91
34.
go back to reference Mehanna H, Beech T, Nicholson T, El-Hariry I, McConkey C, Paleri V, Roberts S (2013) Prevalence of human papillomavirus in oropharyngeal and nonoropharyngeal head and neck cancer—systematic review and meta‐analysis of trends by time and region.Head and Neck.35;747 – 55 Mehanna H, Beech T, Nicholson T, El-Hariry I, McConkey C, Paleri V, Roberts S (2013) Prevalence of human papillomavirus in oropharyngeal and nonoropharyngeal head and neck cancer—systematic review and meta‐analysis of trends by time and region.Head and Neck.35;747 – 55
35.
go back to reference Li W, Thompson CH, O’Brian CJ (2003) HPV positivity predicts favorable outcome for squamous carcinoma of the tonsil. Int J Cancer 106:553–558CrossRef Li W, Thompson CH, O’Brian CJ (2003) HPV positivity predicts favorable outcome for squamous carcinoma of the tonsil. Int J Cancer 106:553–558CrossRef
36.
go back to reference Quon H, O’Malley BW, Weinstein GS.(2010) Transoral robotic surgery (TORS) for the Head and Neck. Current and future indications. Int Jl of Otolaryngology Head and Neck Surgery. 1:133–140 Quon H, O’Malley BW, Weinstein GS.(2010) Transoral robotic surgery (TORS) for the Head and Neck. Current and future indications. Int Jl of Otolaryngology Head and Neck Surgery. 1:133–140
37.
go back to reference Weinstein GS, Quon H, Newman HJ, Chalian JA, Malloy K, Lin A, Desai A, Livolsi VA, Montone KT, Cohen KR, O’Malley BW (2012) Transoral robotic surgery alone for oropharyngeal cancer: an analysis of local control.Arch Otolaryngol–Head & Neck Surg. 138;628 – 34 Weinstein GS, Quon H, Newman HJ, Chalian JA, Malloy K, Lin A, Desai A, Livolsi VA, Montone KT, Cohen KR, O’Malley BW (2012) Transoral robotic surgery alone for oropharyngeal cancer: an analysis of local control.Arch Otolaryngol–Head & Neck Surg. 138;628 – 34
38.
go back to reference De Almeida JR, Li R, Magnuson JS, Smith RV, Moore E, Lawson G, Remacle M, Ganly I, Kraus DH, Teng MS, Miles BA (2015) Oncologic outcomes after transoral robotic surgery: a multi-institutional study. JAMA Otolaryngology–Head & Neck Surgery 141:1043–1051CrossRef De Almeida JR, Li R, Magnuson JS, Smith RV, Moore E, Lawson G, Remacle M, Ganly I, Kraus DH, Teng MS, Miles BA (2015) Oncologic outcomes after transoral robotic surgery: a multi-institutional study. JAMA Otolaryngology–Head & Neck Surgery 141:1043–1051CrossRef
39.
go back to reference Gorphe C, Simon C (2019) A systematic review and met analysis in transoral robotic surgery for orpharyngeal carcinoma. Oral Oncol 98:69–77CrossRef Gorphe C, Simon C (2019) A systematic review and met analysis in transoral robotic surgery for orpharyngeal carcinoma. Oral Oncol 98:69–77CrossRef
40.
go back to reference Moore EJ, Van Abel KM, Price DL, Lohse CM, Olsen KD, Jackson RS et al (2018) Transoral robotic surgery for oropharyngeal carcinoma:Surgical margins and oncologic outcomes.Head and Neck.40;747 – 55 Moore EJ, Van Abel KM, Price DL, Lohse CM, Olsen KD, Jackson RS et al (2018) Transoral robotic surgery for oropharyngeal carcinoma:Surgical margins and oncologic outcomes.Head and Neck.40;747 – 55
41.
go back to reference Moore EJ, Henstrom DK, Olsen KD, Kasperbauer JL, McGree ME (2009) Transoral resection of tonsillar squamous cell carcinoma.The Laryngoscope.119;508 – 15 Moore EJ, Henstrom DK, Olsen KD, Kasperbauer JL, McGree ME (2009) Transoral resection of tonsillar squamous cell carcinoma.The Laryngoscope.119;508 – 15
42.
go back to reference Hinni ML, Zarka MA, Hoxworth JM (2013) Margin mapping in transoral surgery for head and neck cancer. The Laryngoscope. 123;1190-8 Hinni ML, Zarka MA, Hoxworth JM (2013) Margin mapping in transoral surgery for head and neck cancer. The Laryngoscope. 123;1190-8
43.
go back to reference Hanna J, Morse E, Brauer PR, Judson B, Mehra S (2019) Positive margin rates and predictors in transoral robotic surgery after federal approval. A National quality study. Head Neck 41:3064–3072CrossRef Hanna J, Morse E, Brauer PR, Judson B, Mehra S (2019) Positive margin rates and predictors in transoral robotic surgery after federal approval. A National quality study. Head Neck 41:3064–3072CrossRef
44.
go back to reference White H, Ford S, Bush B, Holsinger FC, Moore E, Ghanem T, Carroll W et al (2013) Salvage surgery for recurrent cancers of the oropharynx: comparing TORS with standard open surgical approaches.JAMA Otolaryngology–Head & Neck Surgery. 139;773-7 White H, Ford S, Bush B, Holsinger FC, Moore E, Ghanem T, Carroll W et al (2013) Salvage surgery for recurrent cancers of the oropharynx: comparing TORS with standard open surgical approaches.JAMA Otolaryngology–Head & Neck Surgery. 139;773-7
45.
go back to reference Dabas S, Deqan A, Ranjan R, Deqan AK, Puri A, Shah SH et al (2015) Transoral robotic surgery in management of oropharyngeal cancers.:a preliminary experience at a tertiary cancer centre. in India. Int J clin Oncol 20:693–700CrossRef Dabas S, Deqan A, Ranjan R, Deqan AK, Puri A, Shah SH et al (2015) Transoral robotic surgery in management of oropharyngeal cancers.:a preliminary experience at a tertiary cancer centre. in India. Int J clin Oncol 20:693–700CrossRef
46.
go back to reference Sinclair CF, McColloch NL, Caroll NR, Rosenthal EL, Desmond RA, Magnuson JS et al (2011) Patient perceived and objective functional outcomes following transoral robotic surgery for early oropharyngeal carcinoma. Arch otolaryngol-Head Neck Surg 137:1112–1116CrossRef Sinclair CF, McColloch NL, Caroll NR, Rosenthal EL, Desmond RA, Magnuson JS et al (2011) Patient perceived and objective functional outcomes following transoral robotic surgery for early oropharyngeal carcinoma. Arch otolaryngol-Head Neck Surg 137:1112–1116CrossRef
Metadata
Title
Analysis of Outcomes following TORS in a Mixed Cohort of Recurrent and New T1-T2 Oropharyngeal Cancer- A Single Institution Study
Authors
Naresh K Panda
Archit Kapoor
Nitika Goel
Sushmita Ghoshal
Varinder Singh
Amanjit Bal
Publication date
09-09-2022
Publisher
Springer India
Published in
Indian Journal of Otolaryngology and Head & Neck Surgery / Issue 4/2022
Print ISSN: 2231-3796
Electronic ISSN: 0973-7707
DOI
https://doi.org/10.1007/s12070-022-03139-5

Other articles of this Issue 4/2022

Indian Journal of Otolaryngology and Head & Neck Surgery 4/2022 Go to the issue