Clinical Characteristics and Treatment Outcomes of Oral Cancers Using Transoral Robotic Surgery in an Endemic Region

Abstract

Oral cancer poses a major health challenge in Taiwan, consistently ranking among the highest globally in both incidence and cancer-related mortality. Transoral robotic surgery (TORS) has potential advantages over open surgery, but its long-term oncologic outcomes are not well established. In this study, we sought to elucidate the role of TORS in improving treatment outcomes among oral cancer patients. A case–control study with propensity score matching was conducted in a single teaching hospital in Taiwan. It included 72 oral cancer patients in each group to analyze and compare survival outcomes between the surgical approaches. The TORS group demonstrated a higher negative resection margin rate, a lower mortality risk and better overall survival than the open-surgery group. Multivariate Cox regression analysis confirmed TORS’s association with a reduced risk of death. Kaplan–Meier survival analysis and log-rank tests indicated significantly better survival outcomes for the TORS group across all cancer stages. Moreover, the TORS group exhibited improved overall survival rates for stage III and IV patients compared to the conventional open-surgery group. In conclusion, this study suggests that TORS may offer better overall survival rates and potential advantages over conventional surgery for oral cancer treatment.

Transoral Robotic Surgery for Oral Cancer: Evaluating Surgical Outcomes in the Presence of Trismus

“…Another cross-sectional study emphasized the need for early identification and proactive management of trismus, thereby amplifying the potential for improved therapeutic outcomes [ 15 ]. Furthermore, a recent study by Chang et al posited the promising role of TORS in enhancing treatment precision for oral cancer [ 16 ]. While magnification loupes can assist with visualization, TORS provides unparalleled optics and maneuverability via three-dimensional imaging and wristed instruments.…”

“…While magnification loupes can assist with visualization, TORS provides unparalleled optics and maneuverability via three-dimensional imaging and wristed instruments. These attributes help maximize tumor identification and negative margins [ 16 , 17 ], which are surgical features especially crucial within the limited oral cavity space in patients with trismus. For advanced tumors, TORS facilitates access to deep buccal and tongue base lesions considered inaccessible or overly morbid with traditional approaches [ 18 ].…”

“…Despite the existing research, there is a noticeable lack of studies elucidating the nuanced relationship between pre-treatment trismus and surgical outcomes in Taiwanese male oral cancer patients treated with TORS. This gap is significant, considering the prevalent use of betel quid in Taiwan related to non-oncological trismus and the rising adoption of surgical treatment alternatives [ 16 , 19 ]. Understanding this relationship is crucial for formulating comprehensive treatment strategies tailored to the unique challenges faced by this specific demographic and improving survival rates.…”