Transoral robotic surgery for glottic squamous cell carcinoma: a systematic review and patient-level analysis of surgical, functional, and oncologic outcomes.

Evidence regarding the role of transoral robotic surgery (TORS) in glottic squamous cell carcinoma (GLSCC) remains limited. This systematic review aimed to evaluate the surgical, functional, and oncologic outcomes of TORS for GLSCC through a patient-level analysis. A PRISMA-compliant systematic review was conducted using PubMed, Scopus, and the Cochrane Library through 31 May 2026. Surgical, functional, and oncologic outcomes were extracted, and Kaplan-Meier analyses were performed when patient-level follow-up data were available. Fifteen studies including 134 patients were analyzed, comprising 91 robotic cordectomies, 21 robotic partial laryngectomies, and 22 robotic total laryngectomies. Robotic cordectomy was associated with short operative times (20.0 ± 10.8 min), minimal blood loss (13.2 ± 9.0 mL), and a low conversion rate (2.2%). Temporary tracheostomy, and feeding tube dependence occurred in 4.4%, and 12.4%, respectively. Robotic partial laryngectomy demonstrated favorable functional outcomes, with successful decannulation and feeding tube removal reported in all available cases. Five-year local control, disease-specific survival, and overall survival following robotic cordectomy were 86.5%, 97.5%, and 93.6%, respectively. In the robotic total laryngectomy cohort, 5-year local, regional, and distant disease control rates exceeded 90%, although oncologic outcomes for robotic partial laryngectomy could not be reliably assessed because of insufficient follow-up data. TORS appears to be a feasible treatment option for selected patients with GLSCC, providing encouraging surgical, functional, and oncologic outcomes. However, the available evidence remains limited to small retrospective studies, and larger comparative investigations are needed to better define its role in clinical practice.