Transoral robotic surgery (TORS) for oropharyngeal cancer
Some institutions have restricted TORS cases for oropharyngeal cancer36, with the knowledge that radiation or
chemoradiation have comparable survival outcomes 37.
We continue to offer TORS to patients who we anticipate have a high
likelihood of requiring single modality treatment. During the reported
three-week period, two such TORS cases were performed and did not
require further treatment while two other cases where TORS could have
been part of multimodality treatment were ultimately recommended for
chemoradiation. TORS may be an option in selected patients, allowing a
single hospital stay versus a 6-7 week course of daily treatment.
However, some cases thought to require surgery only may be
pathologically upstaged and may require adjuvant radiation or
chemoradiation. Also, we acknowledge that the opportunity to offer TORS
may be limited by available resources and institutional guidelines36.
We recognize that resource availability can differ largely between
institutions. Our institution is dedicated to treating cancer patients,
whereas other institutions that provide general care may be inundated
with COVID-19 positive patients. On the other hand, oncology patients
have been proven to be a vulnerable population that our institution is
determined to protect. Also, different regions have or will reach their
COVID-19 surge or peak at different times, affecting how they are able
to practice.