Introduction: Transoral robotic surgery (TORS) has been advocated as a means to de-intensify adjuvant therapy and to improve functional treatment outcomes in advanced stage oropharynx cancer. The purpose of this retrospective investigation is to review our early experience with TORS in the definitive treatment setting and assess local disease control and functional outcomes.

Methods: All patients who underwent TORS and risk-adapted adjuvant radiation therapy or chemoradiotherapy for previously untreated oropharyngeal cancer at our comprehensive cancer center were identified. Demographic and staging information were recorded and outcomes assessed retrospectively by chart review.

Results: A total of 37 TORS oropharyngeal cancer cases among 32 patients were identified. The majority of tumor sites were either tonsillar fossa ( n = 15) or base of the tongue ( n = 17), and all but two patients treated presented with either T1 or T2 disease. No patients had local recurrence at the time of last follow-up (Mean follow-up = 447 days). One patient who refused adjuvant therapy had recurrence in ipsilatral neck. Four patients had PEG tube placed during radiation therapy, and one remains PEG dependent at 6 month follow up.

Conclusion: TORS combined with risk adapted adjuvant therapy for oropharyngeal cancer provided excellent loco-regional control and favorable functional outcomes.