Management of locally advanced HPV-related oropharyngeal squamous cell carcinoma: where are we?

HPV-related (HPV+) oropharyngeal cancer (OPC) has a better prognosis compared to HPV unrelated (HPV−) OPC. This review summarizes and discusses several of the controversies regarding the management of HPV+ OPC, including the mechanism of its treatment sensitivity, modern surgical techniques, chemoth...

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Bibliographic Details
Published in:European archives of oto-rhino-laryngology 2016-10, Vol.273 (10), p.2877-2894
Main Authors: Samuels, Stuart E., Eisbruch, Avraham, Beitler, Jonathan J., Corry, June, Bradford, Carol R., Saba, Nabil F., van den Brekel, Michiel W. M., Smee, Robert, Strojan, Primož, Suárez, Carlos, Mendenhall, William M., Takes, Robert P., Rodrigo, Juan P., Haigentz, Missak, Rapidis, Alexander D., Rinaldo, Alessandra, Ferlito, Alfio
Format: Article
Language:English
Subjects:
Aged
Antineoplastic Agents - therapeutic use
Carcinoma, Squamous Cell - metabolism
Carcinoma, Squamous Cell - pathology
Carcinoma, Squamous Cell - therapy
Chemoradiotherapy
Cyclin-Dependent Kinase Inhibitor p16 - metabolism
Female
Head and Neck Surgery
Humans
Induction Chemotherapy
Male
Medicine
Medicine & Public Health
Middle Aged
Natural Orifice Endoscopic Surgery
Neurosurgery
Oropharyngeal Neoplasms - metabolism
Oropharyngeal Neoplasms - pathology
Oropharyngeal Neoplasms - therapy
Otorhinolaryngology
Papillomaviridae
Papillomavirus Infections - complications
Papillomavirus Infections - metabolism
Prognosis
Radiation Tolerance
Review Article
Smoking - adverse effects
Smoking - mortality
Tumor Escape
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Summary:HPV-related (HPV+) oropharyngeal cancer (OPC) has a better prognosis compared to HPV unrelated (HPV−) OPC. This review summarizes and discusses several of the controversies regarding the management of HPV+ OPC, including the mechanism of its treatment sensitivity, modern surgical techniques, chemotherapy regimens, and treatment de-intensification protocols. We also discuss and reconsider potential adverse prognostic factors such as tumor EGFR expression, tumor hypoxia, and patient smoking history, as well as the significance of retropharyngeal adenopathy. Finally, we discuss elective nodal treatment of uninvolved lymph node stations. While this review does not exhaust all controversies related to the management of HPV+ OPC, it aims to highlight some of the most clinically relevant ones.
ISSN:0937-4477
1434-4726
DOI:10.1007/s00405-015-3771-x