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A Comprehensive Analysis of Socio-economic and Clinical Factors in Head and Neck Cancer Patients Receiving Robotic Surgery

Published online by Cambridge University Press:  24 July 2025

Darby Keirns ,
Beau Hsia Open the ORCID record for Beau Hsia [Opens in a new window] ,
Paula Valeria Guerra-Navarro ,
Xinxin Wu ,
Peter Silberstein ,
James Reed Gardner  and
Vijay Patel
Darby Keirns
Affiliation:
Department of Otolaryngology–Head and Neck Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA
Beau Hsia*
Affiliation:
Creighton University School of Medicine, Phoenix, AZ, USA
Paula Valeria Guerra-Navarro
Affiliation:
Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
Xinxin Wu
Affiliation:
School of Medicine, Creighton University, Omaha, NV, USA
Peter Silberstein
Affiliation:
Department of Medicine, Hematology and Oncology, School of Medicine, Creighton University, Omaha, NV, USA
James Reed Gardner
Affiliation:
Department of Otolaryngology–Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA
Vijay Patel
Affiliation:
Division of Pediatric Otolaryngology, Rady Children’s Hospital, San Diego, CA, USA
*
Corresponding author: Beau Hsia; Email: beauhsiacreighton@gmail.com
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Abstract

Objectives

To investigate socio-economic and clinical disparities in the utilisation of robotic surgery for head and neck cancer.

Methods

Using the National Cancer Database (2010–2020), 212 449 surgically treated patients were analysed. Multivariate logistic regression identified predictors of robotic versus non-robotic surgery (p < 0.05).

Results

Robotic surgery utilisation increased over time during the study period. The following characteristics positively correlated with the use of robotic surgery: male, aged 41–80 years, White race, insured (with private insurance, Medicaid and Medicare) and treatment at an Academic/Research centre. Metropolitan residency, higher income/education levels, lower comorbidity (Charlson–Deyo score of 0) and Stage I disease were also associated with increased robotic surgery utilisation.

Conclusion

Significant socio-economic disparities exist in robotic surgery access, potentially exacerbating outcome inequities. Targeted interventions are needed to improve equity in treatment access and standardise care protocols. Further research should validate trends and address systemic barriers.

Keywords

RoboticsHead and Neck NeoplasmsOtorhinolaryngologic Surgical ProceduresNasopharyngeal NeoplasmsParotid Neoplasms

Information

Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 139 , Issue 11 , November 2025 , pp. 1062 - 1069
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

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Footnotes

Presented as an oral presentation at the AAO-HNSF 2023 Annual Meeting & OTO Experience in Nashville, Tennessee on 3 October, 2023.

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