To TORS or Not to TORS: but is that the question? Comment on 'transoral robotic surgery for advanced oropharyngeal carcinoma'.

摘要

National Cancer Center Network guidelines for the treatment of locally advanced squamous cell cancer of the oropharynx are broad. Related to precise site and tumor staging, recommendations vary from chemoradiotherapy, to surgery with or without adjuvant therapy based on the surgical pathologic findings, to induction chemotherapy followed by locore-gional therapy. Randomized trials have been performed, but most often the focus has been on the potential role of systemic therapy tested either as a radiation-sensitizing concomitant strategy with the objective of improving locoregional disease control or as a component of a sequential treatment program with higher chemotherapy dose levels. Surgery and radiotherapy are powerful local treatments, but which patients should undergo surgery remains a conundrum.