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.