Transoral Robotic Surgery for Oropharyngeal Squamous Cell Carcinoma: Glossotonsillar Sulcus Involvement Conveys an Unfavorable Oncological Outcome.

BACKGROUND: Transoral robotic surgery (TORS) is widely used in management of early-stage primary oropharyngeal squamous cell carcinoma (OPSCC). Tumors involving the glossotonsillar sulcus (GTS) are hypothesized to confer worse oncological outcomes compared to those situated in the rest of the oropharynx, with a paucity of evidence to support this theory. METHODS: An observational cohort study of consecutive adult patients undergoing TORS for pT1-2 oropharyngeal cancers identified over an eight-year period was conducted. Patients were stratified by oropharyngeal subsite with data collected on patient and tumor characteristics, including histopathological features, and subjected to survival analysis. RESULTS: A total of 153 patients were included, with 52 having tumors involving the GTS. Those with GTS-involving tumors showed a significantly worse overall survival than patients without. GTS-involving cancers exhibited a lower proportion of clear margins, and a higher incidence of perineural involvement. CONCLUSIONS: GTS involvement conveys a worse prognosis for oropharyngeal cancer patients treated with TORS.