Transoral robotic approach to carcinoma of unknown primary

Head Neck. 2014 Jun;36(6):848-52. doi: 10.1002/hed.23385. Epub 2013 Sep 2.


Background: The management of carcinoma of unknown primary (CUP) is one of the challenging conditions in head and neck oncologic surgery. Despite various diagnostic tools, the primary tumor site in more than half of cases remains unidentified. The purpose of this study was to assess the feasibility and efficiency of utilizing transoral robotic surgery (TORS) for the diagnosis and treatment of CUP in the head and neck.

Methods: In this prospective, single-institutional, clinical TORS trial, 22 of 181 patients were treated for CUP between 2008 and 2012.

Results: Among all those 22 patients, primary tumor site identification and complete tumor removal was achieved in 17 patients (77.3%) with TORS. Tonsil (59.1%) and base of tongue (18.1%) were identified as the most common tumor locations.

Conclusion: Together with panendoscopy, directed biopsies, and positron emission tomography (PET)/CT, TORS is a valuable option in the identification and treatment of primary tumor sites.

Keywords: carcinoma of unknown primary; daVinci; transoral robotic surgery.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / diagnosis
  • Carcinoma, Squamous Cell / secondary
  • Carcinoma, Squamous Cell / surgery*
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Natural Orifice Endoscopic Surgery / methods*
  • Neck Dissection
  • Neoplasms, Unknown Primary*
  • Prospective Studies
  • Risk Factors
  • Robotic Surgical Procedures / methods*
  • Smoking / adverse effects
  • Tongue Neoplasms / diagnosis
  • Tongue Neoplasms / secondary
  • Tongue Neoplasms / surgery*
  • Tonsillar Neoplasms / diagnosis
  • Tonsillar Neoplasms / secondary
  • Tonsillar Neoplasms / surgery*
  • Treatment Outcome