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Case Reports in Oncological Medicine
Volume 2013, Article ID 727904, 4 pages
Case Report

Lack of Adjuvant Radiotherapy May Increase Risk of Retropharyngeal Node Recurrence in Patients with Squamous Cell Carcinoma of the Head and Neck after Transoral Robotic Surgery

1Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY 10461, USA
2Department of Radiation Oncology, Beth Israel Medical Center, New York, NY 10003, USA

Received 18 March 2013; Accepted 26 May 2013

Academic Editors: P. De Nardi and S. Landen

Copyright © 2013 Waleed F. Mourad et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. Transoral robotic surgery (TORS) has increased in popularity in the management of squamous cell carcinoma of the head and neck. However, TORS does not address the neck or retropharyngeal nodes (RPN). In the current report, we highlight the impact of the lack of adjuvant radiotherapy on RPN recurrence after TORS. Materials and Methods. A 58-year-old Caucasian male presented with squamous cell carcinoma of the head and neck of unknown primary. He was offered radiotherapy as a definitive management for clinical stage T0N2aM0, stage IVA, but he opted to left neck dissection. Follow-up PET-CT scan revealed recurrence in the left base of tongue and right level II lymph node. He was offered radiotherapy which he declined and opted to TORS and right neck dissection. Follow-up PET-CT scan showed recurrence in left RPN for which he underwent salvage concurrent chemoradiotherapy to 70 Gy. Results. After a followup of 9 months from the date of salvage chemoradiotherapy completion, the patient is with no evidence of disease. Conclusions. TORS followed by adjuvant radiotherapy seems reasonable in the context of squamous cell carcinoma of the head and neck due to the odds of RPN involvement. Further reports are warranted to optimize post-TORS adjuvant treatment.