{Reference Type}: Journal Article {Title}: Ninety-day mortality following transoral robotic surgery or radiation at Commission on Cancer-accredited facilities. {Author}: Janopaul-Naylor JR;Rupji M;Tobillo RA;Lorenz JW;Switchenko JM;Tian S;Kaka AS;Qian DC;Schlafstein AJ;Steuer CE;Remick JS;Rudra S;McDonald MW;Saba NF;Stokes WA;Patel MR;Bates JE; {Journal}: Head Neck {Volume}: 45 {Issue}: 3 {Year}: 03 2023 {Factor}: 3.821 {DOI}: 10.1002/hed.27282 {Abstract}: Postoperative mortality for oropharynx squamous cell carcinoma (OPSCC) with transoral robotic surgery (TORS) varies from 0.2% to 6.5% on trials; the real-world rate is unknown.
NCDB study from 2010 to 2017 for patients with cT1-2N0-2M0 OPSCC with Charleson-Deyo score 0-1. Ninety-day mortality assessed from start and end of treatment at Commission on Cancer-accredited facilities.
3639 patients were treated with TORS and 1937 with radiotherapy. TORS cohort had more women and higher income, was younger, more often treated at academic centers, and more likely to have private insurance (all pā€‰<ā€‰0.05). Ninety-day mortality was 1.3% with TORS and 0.7% or 1.4% from start or end of radiotherapy, respectively. From end of therapy, there was no significant difference on MVA between treatment modality.
There is minimal difference between 90-day mortality in patients treated with TORS or radiotherapy for early-stage OPSCC. While overall rates are low, for patients with expectation of cure, work is needed to identify optimal treatment.