{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T14:46:48Z","timestamp":1792075608563,"version":"4.4.0"},"reference-count":34,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Otolaryngology - Head &amp; Neck Surgery"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Importance:<\/jats:title>\n                    <jats:p>Pathologic risk features after transoral robotic surgery (TORS) inform the need for adjuvant therapy in oropharyngeal cancer (OPC); however, traditional risk stratification criteria may not fully apply to oropharyngeal carcinoma treated with TORS, especially for HPV+ disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>The purpose of this study was to determine oncological outcomes including disease-free survival and overall survival in patients with intermediate-risk and high-risk histopathological features who underwent TORS without adjuvant radiation therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>We conducted a cohort study of patients with OPC, with intermediate-risk and high-risk pathological features who underwent primary TORS with neck dissection and without adjuvant treatment between 2015 and 2023 at the Princess Margaret Care Centre in Toronto, Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting\/Participants:<\/jats:title>\n                    <jats:p>Adult patients with a diagnosis of oropharyngeal carcinoma treated at the Princess Margaret Cancer Center\/University Health Network between January 2015 and December 2023 were included in the study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention:<\/jats:title>\n                    <jats:p>Transoral robotic surgical removal of primary oropharyngeal carcinoma with concurrent neck dissection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures:<\/jats:title>\n                    <jats:p>Oncologic outcomes assessed included local, regional, and distant recurrence along with disease-free survival (DFS) and overall survival (OS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Forty-two patients (27 male: 15 female; median age\u2009=\u200958) with 43 primary oropharyngeal cancers were included, of whom 33 (79%) were p16 positive. At a median follow-up of 49\u2009months, 41 patients (98%) remained disease-free. Three patients (7%) developed second primaries in different sites that were successfully salvaged.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Patients with OPC treated with TORS alone have favorable oncologic outcomes, although second primary tumors remain a risk, likely related to field cancerization or multifocality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance:<\/jats:title>\n                    <jats:p>Overall survival and locoregional control do not appear to be compromised in patients with OPSCC and adverse intermediate-to-high\u2013risk features on histopathology who do not proceed to adjuvant therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19160216261477650","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:07:43Z","timestamp":1791893263000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Oncological Outcomes of Transoral Robotic Surgery and Neck Dissection Without Adjuvant Therapy in Patients With Low-, Intermediate-, and High-Risk Pathological Features in Oropharyngeal Carcinoma\u2014An Institutional Experience"],"prefix":"10.1177","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3791-4925","authenticated-orcid":false,"given":"Leba M.","family":"Sarkis","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Princess Margaret Cancer Centre, University Health Network, University of Toronto, ON, Canada"},{"name":"Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, ON, Canada"},{"name":"Sydney Medical School, University of Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeynep","family":"Baskurt","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University Health Network, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher Mkl","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Princess Margaret Cancer Centre, University Health Network, University of Toronto, ON, Canada"},{"name":"Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Tzelnick","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Princess Margaret Cancer Centre, University Health Network, University of Toronto, ON, Canada"},{"name":"Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shao Hui","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Health Network, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Hosni","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Health Network, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ezra","family":"Hahn","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Health Network, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Bratman","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Health Network, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Spreafico","sequence":"additional","affiliation":[{"name":"Princess Margaret Hospital, Princess Margaret Hospital, Department of Medical Oncology and Hematology, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Princess Margaret Cancer Centre, University Health Network, University of Toronto, ON, Canada"},{"name":"Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John R.","family":"de Almeida","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Princess Margaret Cancer Centre, University Health Network, University of Toronto, ON, Canada"},{"name":"Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","unstructured":"Lechner M Liu J Masterson L Fenton TR. 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