Clinical Characteristics and Treatment Outcomes of Oral Cancers Using Transoral Robotic Surgery in an Endemic Region

SIMPLE SUMMARY: Oral cancer is a significant health problem in Taiwan, with high rates of occurrence and cancer-related deaths. Transoral robotic surgery (TORS) is an innovative surgical approach that might offer treatment advantages and improve outcomes. We conducted a study in a Taiwanese hospital with 72 patients in each group, comparing TORS to conventional open surgery over three years. After carefully matching the patients, we found that those who had TORS had a better overall survival compared to the open-surgery group. We used various analyses to confirm that TORS was linked to a lower risk of death. The TORS group had significantly better survival rates at all stages of cancer, and it was particularly effective for late stages, i.e., stage III and IV patients. In conclusion, our study suggests that TORS could be a better option for treating oral cancer in Taiwan, offering improved chances of survival and potential advantages over conventional surgery. ABSTRACT: Oral cancer poses a major health challenge in Taiwan, consistently ranking among the highest globally in both incidence and cancer-related mortality. Transoral robotic surgery (TORS) has potential advantages over open surgery, but its long-term oncologic outcomes are not well established. In this study, we sought to elucidate the role of TORS in improving treatment outcomes among oral cancer patients. A case–control study with propensity score matching was conducted in a single teaching hospital in Taiwan. It included 72 oral cancer patients in each group to analyze and compare survival outcomes between the surgical approaches. The TORS group demonstrated a higher negative resection margin rate, a lower mortality risk and better overall survival than the open-surgery group. Multivariate Cox regression analysis confirmed TORS’s association with a reduced risk of death. Kaplan–Meier survival analysis and log-rank tests indicated significantly better survival outcomes for the TORS group across all cancer stages. Moreover, the TORS group exhibited improved overall survival rates for stage III and IV patients compared to the conventional open-surgery group. In conclusion, this study suggests that TORS may offer better overall survival rates and potential advantages over conventional surgery for oral cancer treatment.