Small apples and big oranges.
There’s one big problem with many of the retrospective studies out there comparing outcomes with transoral robotic surgery (TORS) versus radiation for head and neck cancers: radiation is commonly used for much more advanced cases meaning worse survival and worse toxicity. Here’s a look at all cases of T1-2N0 oropharyngeal cancer treated with radiation +/- chemo at a single center in Ontario (n=198) reporting rates of G-tube dependence at one year of 2.5% and two years 1% with five-year overall survival of 86% for HPV(+) disease. In other words, outcomes compare favorably to TORS. | Di Gravio, Radiat Oncol 2020