Association of HPV Status With Quality of Life After Transoral Robotic Surgery for T1–T2 Oropharyngeal Carcinoma

BACKGROUND: In T1-T2 oropharyngeal squamous cell carcinoma (OPSCC), factors associated with patient-reported quality of life after transoral robotic surgery (TORS) are poorly defined. METHODS: Retrospective cohort of 59 patients with T1-T2 OPSCC treated with TORS. Swallowing-related quality of life (MD Anderson Dysphagia Inventory, MDADI) and EORTC QLQ-C30/QLQ-H&N35 scores were analyzed with mixed-effects models adjusted for HPV status, subsite, adjuvant treatment and, in sensitivity analyses, lifestyle factors, age, tumor stage, and preoperative scores. RESULTS: HPV-positive status was independently associated with higher MDADI scores (β = 12.39, p = 0.001), including after adjustment for preoperative scores (β = 16.0, p = 0.004), and with lower QLQ-H&N35 symptom burden (β = -9.5, p = 0.012). Adjuvant radiotherapy was associated with lower MDADI scores (β = -7.92, p = 0.021), attenuated after adjustment for tumor stage. Tumor subsite was not associated with outcomes. CONCLUSIONS: HPV-positive patients report better swallowing-related quality of life after TORS, independently of preoperative scores.