A world-first trial comparing radiotherapy with robotic surgery for oropharyngeal squamous cell carcinoma has concluded that radiotherapy may have the edge when it comes to post-op swallowing scores.

The randomised controlled trial in 68 patients, including two from the Royal Adelaide Hospital, goes against earlier observational studies favouring transoral robotic surgery plus neck dissection over radiotherapy.

It has also raised concerns that bleeding risk using transoral robotic surgery may be underrecognised, after one patient died from bleeding during surgery, the authors report.

The main outcome of the trial, which also recruited patients from five Canadian hospitals, was patients’ assessment of their swallowing capability one year after treatment as measured by the MD Anderson Dysphagia Inventory (MDADI).