{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T15:36:24Z","timestamp":1787931384862,"version":"build-2784847793"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,11,11]],"date-time":"2021-11-11T00:00:00Z","timestamp":1636588800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30 CA016672"],"award-info":[{"award-number":["P30 CA016672"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2022,2,15]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Transoral robotic surgery (TORS) was approved by the Food and Drug Administration in 2009 for the treatment of oropharyngeal cancers (oropharyngeal squamous cell carcinoma [OPSCC]). This study investigated the adoption and safety of TORS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients who underwent TORS for OPSCC in the National Cancer Data Base from 2010 to 2016 were selected. Trends in the positive margin rate (PMR), 30\u2010day unplanned readmission, and early postoperative mortality were evaluated. Outcomes after TORS, nonrobotic surgery (NRS), and nonsurgical treatment were compared with matched\u2010pair survival analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 2010 to 2016, among 73,661 patients with OPSCC, 50,643 were treated nonsurgically, 18,024 were treated with NRS, and 4994 were treated with TORS. TORS utilization increased every year from 2010 (n = 363; 4.2%) to 2016 (n = 994; 8.3%). The TORS PMR for base of tongue malignancies decreased significantly over the study period (21.6% in 2010\u20102011 vs 15.8% in 2015\u20102016; <jats:italic>P<\/jats:italic> = .03). The TORS PMR at high\u2010volume centers (\u226510 cases per year; 11.2%) was almost half that of low\u2010volume centers (&lt;10 cases per year; 19.3%; <jats:italic>P<\/jats:italic> &lt; .001). The rates of 30\u2010day unplanned readmission (4.1%) and 30\u2010day postoperative mortality (1.0%) after TORS were low and did not vary over time. High\u2010volume TORS centers had significantly lower rates of 30\u2010day postoperative mortality than low\u2010volume centers (0.5% vs 1.5%; <jats:italic>P<\/jats:italic> = .006). In matched\u2010pair analyses controlling for clinicopathologic cofactors, 30\u2010, 60\u2010, and 90\u2010day posttreatment mortality did not vary among patients with OPSCC treated with TORS, NRS, or nonsurgical treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>TORS has become widely adopted and remains safe across the country with a very low risk of severe complications comparable to the risk with NRS. Although safety is excellent nationally, high\u2010volume TORS centers have superior outcomes with lower rates of positive margins and early postoperative mortality.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.33995","type":"journal-article","created":{"date-parts":[[2021,11,11]],"date-time":"2021-11-11T10:48:44Z","timestamp":1636627724000},"page":"685-696","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Transoral robotic surgery adoption and safety in treatment of oropharyngeal cancers"],"prefix":"10.1002","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2664-7756","authenticated-orcid":false,"given":"Jamie R.","family":"Oliver","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery New York University Grossman School of Medicine New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4436-8336","authenticated-orcid":false,"given":"Michael J.","family":"Persky","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery New York University Grossman School of Medicine New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3435-3424","authenticated-orcid":false,"given":"Binhuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Population Health New York University Grossman School of Medicine New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1968-3756","authenticated-orcid":false,"given":"Umamaheswar","family":"Duvvuri","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Pittsburgh School of Medicine Pittsburgh Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9427-0743","authenticated-orcid":false,"given":"Neil D.","family":"Gross","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery Division of Surgery The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9108-1541","authenticated-orcid":false,"given":"Alec E.","family":"Vaezi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery New York University Grossman School of Medicine New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4417-2280","authenticated-orcid":false,"given":"Luc G. 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