Robot-assisted and endoscopic surgery for head and neck tumors: comparative effectiveness and prospects for combination with immunotherapy



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Abstract

This systematic review aims to conduct a comparative analysis of the clinical effectiveness of robot-assisted (TORS/RAND) and endoscopic (TOES/TLM/ELPS) surgery in the treatment of head and neck tumors, as well as to assess the prospects for their integration into combined regimens with immunotherapy. Based on the analysis of 26 studies selected according to PICO criteria, it has been established that both minimally invasive approaches demonstrate comparable and high indicators of oncological safety (overall and recurrence-free survival) in early and intermediate stages, especially in the context of HPV-positive oropharyngeal cancer. A key clinical advantage is their role in treatment de-escalation strategies, which allow for reducing the volume of or avoiding adjuvant radiotherapy, directly improving functional outcomes and patient quality of life.

The conducted analysis revealed that the technical differences between the methods form unique profiles that may determine their niche in modern immuno-oncology. Robot-assisted surgery, providing standardized technique and obtaining high-quality biomaterial, appears optimal for strategies aimed at subsequent development of personalized vaccines or targeted therapy. In turn, the precision and minimal invasiveness of endoscopic methods may theoretically contribute to better preservation of the tumor immune microenvironment, which is particularly relevant when applying neoadjuvant immunotherapy. To confirm these hypotheses and optimize the choice of method, further prospective studies are required, evaluating not only surgical but also immunological outcomes.

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: ЭЛ № ФС 77 - 80673 от 23.03.2021 г.