{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T16:55:03Z","timestamp":1788022503385,"version":"build-2784847793"},"reference-count":43,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,5,25]],"date-time":"2020-05-25T00:00:00Z","timestamp":1590364800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Transoral robotic surgery (TORS) is increasingly used in head and neck surgery and in carcinoma of unknown primary (CUP) origin specifically. Due to the rising incidence of human papillomavirus (HPV)\u2010related oropharyngeal squamous cell carcinoma (OPSCC), there is a rationale for finding ways to de\u2010escalate treatment strategies. This review aims to test the hypothesis that TORS is a meaningful adjunct in the diagnostic (and therapeutic) pathway in CUP in head and neck.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A structured search of the literature was performed with the search terms \u2018TORS\u2019 and \u2018Carcinoma of Unknown Primary\u2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred and seventy four cases of CUP in which TORS was used were identified for further analysis. Workup for CUP was comparable in all series with regard to physical examination, fine and\/or gross needle examination of cervical nodes, fibre optic endoscopy, imaging and robot assisted mucosectomy of the base of tongue (BOT). Identification rate of the primary tumour was 72% on average (range 17%\u2010 90%), and 55%\u2010 96% were HPV positive. Clear margins were achieved in 60% (range 0%\u201085%) of resected occult tumours. Complication rate of TORS BOT mucosectomy was low with mainly grade I\u2010III sequelae according to Clavien\u2013Dindo.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Transoral robotic surgery seems to be a useful and safe adjunct in the diagnostic and therapeutic pathway in case of CUP in an era of increasing incidence of HPV\u2010positive OPSCC.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.13565","type":"journal-article","created":{"date-parts":[[2020,5,5]],"date-time":"2020-05-05T12:51:27Z","timestamp":1588683087000},"page":"732-738","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["A systematic review on Transoral robotic surgery (TORS) for carcinoma of unknown primary origin: Has tongue base mucosectomy become indispensable?"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7759-7461","authenticated-orcid":false,"given":"Stijn","family":"van Weert","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\/Head and Neck Surgery Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4579-3249","authenticated-orcid":false,"given":"Johannes A.","family":"Rijken","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\/Head and Neck Surgery Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Plantone","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology University of Bari Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Bloemena","sequence":"additional","affiliation":[{"name":"Department of Pathology and Department of Oral and Maxillofacial Surgery\/Pathology Amsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA) Cancer Center Amsterdam Vrije Universiteit Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marije R.","family":"Vergeer","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgit I.","family":"Lissenberg\u2010 Witte","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Ren\u00e9","family":"Leemans","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\/Head and Neck Surgery Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.9-3-330"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2-3-142"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21898"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2015.3228"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdy060"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24300"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.25026"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12105-015-0616-2"},{"key":"e_1_2_9_10_1","unstructured":"National Comprehensive Cancer Network.NCCN Clinical Practice Guidelines in Oncology: Head and Neck Cancers. 2017;V3.2019.https:\/\/www.nccn.org\/professionals\/physician_glsf_guidelines.asp. 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