© American Academy of Otolaryngology-Head and Neck Surgery Foundation 2014 Reprints and permission. Results. As a whole, patients treated with transoral roboticsurgery survived more frequently (94%, 91%, 89% at 1, 2, 3years, respectively) than those treated with open surgery(85%, 75%, 73% at 1, 2, 3 years, correspondingly) (P = .035).The subgroup of patients with human papillomavirusnegativemalignancies treated with open surgery survivedwithout recurrence less frequently at 1, 2, and 3 year ratesof 58%, 25%, 25%, respectively (P<.01).Conclusion. These retrospective data suggest that oncologicoutcomes are not being sacrificed when patients withOPSCC are treated with TORS instead of open surgeryregardless of tumor human papillomavirus immunohistochemicalstaining.Objectives. (1) Investigate oncologic survival outcomes and(2) analyze the impact of human papillomavirus status onprognosis in patients with oropharyngeal squamous cell carcinomatreated with transoral robotic versus open surgery.Study Design. Retrospective cohort study.Setting. Tertiary care referral center, University of Alabamaat Birmingham Hospital.Subjects. One hundred thirty total (65 per treatment arm)with primary oropharyngeal squamous cell carcinoma(OPSCC).Methods. Patients treated for primary oropharyngeal squamouscell carcinoma with either transoral robotic (TORS) oropen surgery plus standard of care adjuvant therapy betweenOctober 2004 and March 2012 were matched based onTNM staging before a retrospective chart review was performed.Carcinoma tissue was stained both prospectively andretrospectively with CINtec p16-INK4a kits for surrogatehuman papillomavirus typing. Recurrence-free survival wasused to evaluate the impact of human papillomavirus tumorstatus and method of surgical intervention on prognosis.