经口机器人手术（TORS）越来越多地用于无需辅助治疗的口咽癌治疗。获得安全的手术切缘对于预防局部复发 (LR) 至关重要，但必要的手术切缘尺寸仍然存在争议。对报告原发性 OPSCC 未接受辅助治疗的 TORS 后切缘状态和 LR 的研究进行系统回顾和荟萃分析。搜索发现了 269 篇文章选择纳入 11 例，荟萃分析纳入 406 名患者。 “接近”边际的定义中注意到了异质性。阳性切缘的随机效应汇总率为 7%（95% CI 0.04-0.12，I2=54%，p=0.02），接近切缘率为 7%（95% CI 0.02-0.27，I2=86%，p=< 0.01）。 LR 的随机效应总体率为 6% (95% CI 0.04-0.10, I2 = 11%, p = 0.35), 13% (95% CI 0.02-0.620, I2 = 0%, p = 1.0)正利润率，平局利润率后 3% (95% CI 0.03-0.24，I2 = 23%，p = 0.26)。 LR 的比值比 (OR) 表明，与接近的利润相比，LR 的阳性风险较高（7.5；95% CI 1.31-42.91，I2 = 0%，p = 0.51），并且接近的利润和负的利润之间的 LR 风险略低（2.22；95% CI 0.67-7.38，I2 = 0%，p = 0.8）。缺乏冰冻切片分析（OR 2.91，p = 0.36）和 HPV 阴性疾病（OR 1.68，p = 0.03）与 LR 风险升高相关。TORS 作为独立治疗与 LR 率低相关；然而，边际定义的相当大的异质性阻碍了文献的发展。需要进行更大规模的多中心研究来确定单独使用 TORS 治疗口咽肿瘤所需的精确切缘范围。版权所有 © 2023 Elsevier Ltd。保留所有权利。

Transoral robotic surgery (TORS) is increasingly employed in the management of oropharyngeal cancer without adjuvant treatment. Attaining safe surgical margins is paramount to preventing local recurrence (LR), but the necessary surgical margin dimension remains contentious.Systematic review and meta-analysis of studies reporting margin status and LR following TORS without adjuvant therapy for primary OPSCC.The search identified 269 articles and 11 were selected for inclusion, with 406 patients included in the meta-analysis. Heterogeneity was noted in the definition of "close" margins. Random-effects pooled rate of positive margins was 7 % (95 % CI 0.04-0.12, I2 = 54 %, p = 0.02) and close margins was 7 % (95 % CI 0.02-0.27, I2 = 86 %, p=<0.01). The random-effects overall rate of LR was 6 % (95 % CI 0.04-0.10, I2 = 11 %, p = 0.35), 13 % (95 % CI 0.02-0.620, I2 = 0 %, p = 1.0) after a positive margin, and 3 % (95 % CI 0.03-0.24, I2 = 23 %, p = 0.26) after a close margin. Odds ratio (OR) for LR indicated higher risk of LR for positive compared to close margins (7.5; 95 % CI 1.31-42.91, I2 = 0 %, p = 0.51), and a slightly lower risk of LR between close and negative margins (2.22; 95 % CI 0.67-7.38, I2 = 0 %, p = 0.8). A lack of frozen-section analysis (OR 2.91, p = 0.36) and HPV-negative disease (OR 1.68, p = 0.03) were associated with an elevated risk of LR.TORS as a standalone treatment is associated with low rates of LR; however, the literature is hampered by considerable heterogeneity in margin definitions. Larger multicentre studies are required to determine the precise margin cut-off required for oropharyngeal tumours managed with TORS alone.Copyright © 2023 Elsevier Ltd. All rights reserved.