Thomas Kjaergaard
Transoral robotic surgery
The use of robotics in head and neck cancer and benign disease is explored.
Current research areas include:
the use of robotics as a supplementary diagnostic modality in cancer of unknown primary in the head and neck
the use of robotics as a single modality treatment in early oropharyngeal cancer
cost-effectiveness of transoral robotic surgery compared to other modalities
Future ares of interest include the use of robotics in the treatment of obstructive sleep apnea and tumors in other pharyngeal sites, the larynx, the paraphaoryngeal space, and soft tissues of the neck.
Cancer of unknown primary
Cancer of unknown primary in the head and neck is an increasing challenge and improved diagnostic efficacy is needed. Research within this field focuses on:
evaluation of current diagnostic modalities
evaluation of new methods including transoral robotics
assessment of treatment outcomes based on the DAHANCA-database
exploration of emerging technologies including targeted imaging
Cost-effectiveness in head and neck cancer: treatment and rehabilitation
The costs of head and neck cancer treatment in Denmark is poorly described. A number of projects aim to explore the costs and the cost effectiveness of both radiation therapy and surgery in head and neck cancer
Central airway stenosis: work-up, treatment and outcome
Endoscopic treatment of central airway stenosis is explored. Main areas of interest are: diagnostic techniques, methodology during treatment, and outcomes.
Laryngeal intraepithelial neoplasia and glottic cancer: diagnostic work-up, treatment and outcome
Primary surgical treatment of laryngeal intraepithelial neoplasia and early stage laryngeal cancer (glottic cancer) was introduced in 2012 based on the principles of transoral laser-microsurgery. Along with this approach, new diagnostic techniques were introduced. Research in this field focuses on the efficacy of the diagnostic work-up as well as treatment outcome and morbidity.
Sessions
Description
HPV-associated oropharyngeal squamous cell carcinoma (OPSCC) often presents as carcinoma of unknown primary (CUP), challenging traditional diagnostic and treatment paradigms. With the increasing incidence of HPV-driven disease among younger patients with favorable prognoses, clinical priorities have shifted toward minimizing treatment burden while maintaining oncologic efficacy.
This session will focus on Denmark’s comprehensive national initiative addressing CUP in the HPV era, centered on the implementation of transoral robotic surgery (TORS) mucosectomy as a diagnostic and therapeutic tool. Recently adopted into national guidelines, TORS mucosectomy has proven effective in identifying hidden primaries and guiding tailored therapy. When combined with a structured radiation de-escalation protocol, this strategy allows for significant reduction in treatment toxicity—especially in cases where the primary tumor is definitively located and fully resected.
The session will also address the broader implications of integrating TORS into CUP work-up, including multidisciplinary coordination, patient selection, and the evolving role of surgical pathology in risk stratification. Together with Denmark’s complementary use of circulating tumor HPV-DNA (ctHPV-DNA) for post-treatment surveillance, these developments reflect a national shift toward more individualized, function-preserving management in HPV-associated head and neck cancer.
Internationally relevant, this Danish model demonstrates how evidence-based innovation, when scaled through national policy, can refine diagnostics, support de-intensified therapy, and improve patient outcomes.
Outcome Objectives
By the end of this session, participants will be able to:
Examine the role of TORS mucosectomy in the diagnostic work-up of HPV-associated CUP.
Explain how the Danish national guideline incorporates TORS and supports treatment de-escalation based on surgical findings.
Compare oncologic and functional implications of TORS-guided versus empiric radiation-based approaches.
Recognize key criteria for patient selection and multidisciplinary workflow in implementing TORS for CUP.
Interpret how real-world adoption of TORS and de-escalated therapy can be applied in other national or institutional settings.
Background (references)
see attachment