Controversies in Postoperative Irradiation of Oropharyngeal Cancer After Transoral Surgery.

Transoral surgery (TOS) is a novel technology whose adoption is expanding in the United States and other countries. TOS offers the possibility of a minimally invasive surgical approach to head and neck cancers. Its most frequent application has been in oropharyngeal cancers (OPC), of which most are associated with human papillomavirus (HPV). For HPV-associated OPC, where high response and survival rates are expected, deintensification of standard therapy is a major area of clinical research. In HPV-OPC, traditional pathologic risk factors indicating a need for adjuvant radiation or chemoradiation may not apply as strongly.