Transoral Robotic Surgery to Treat Head and Neck Cancer (Podcast)

Human papillomavirus-related cancer of the oral pharynx is the only head and neck cancer still on the rise in the United States. Fortunately, because patients with HPV-related cancer tend to be younger, healthier non-smokers, they have a better prognosis and longer survivorship than patients with HPV-unrelated cancers. That makes transoral robotic surgery an excellent treatment option.

“Transoral robotic surgery has become the standard for oropharyngeal cancer over the past decade and has helped de-intensify or reduce the cancer treatment in proper patients,” says Jamie Ku, MD, an otolaryngology head and neck surgeon at Cleveland Clinic specializing in complex cancers.

In a recent episode of Cleveland Clinic’s Head and Neck Innovations podcast, Dr. Ku discusses transoral robotic surgery and other innovations in the field of oropharyngeal cancer. She shares insight on:

• The evolution of transoral robotic surgery from its original platform to new single-port technology
• Patient considerations for the procedure
• The importance of a multidisciplinary team in treating oropharyngeal cancer, including surgeons, radiation oncologists, medical oncologists, speech-language pathologists and others
• Emerging technologies in oropharyngeal cancer, including the use of biomarkers and precision oncology

Click the podcast player above to listen to the episode now, or read on for a short edited excerpt. Check out more Head and Neck Innovations episodes at clevelandclinic.org/podcasts/head-and-neck-innovations or wherever you get your podcasts.

Excerpt from the podcast

Podcast host Paul Bryson, MD, MBA: Which patients seem to be better candidates for transoral robotic surgery?

Dr. Ku: In order to maximize the benefit of utilizing such a technology like the single port system for transoral robotic surgery, really proper patient selection is the most important factor. In general, the way we view the role of transoral robotic surgery in HPV-related favorable disease patients is really to de-intensify or reduce treatment that is necessary to treat and cure the cancer, but also minimize the side effects.

And so, patients who may benefit from this surgery are those with early-stage smaller tumors with limited lymph node involvement in the neck. And even in patients who do smoke or have HPV-unrelated disease, there's a role for this kind of technology and surgery. Really, the goal is to again, either avoid radiation or chemotherapy or minimize radiation and chemotherapy.

I say usually about 20% to 30% of patients with these oropharyngeal cancers are ideal candidates for this. And, it really takes a multidisciplinary team of head and neck cancer experts to best determine their personalized treatment plan and whether or not transoral robotic surgery will be part of their care plan package.