Oropharyngeal cancer and human papilloma virus: evolving diagnostic and management paradigms

Authors

Lisa Buckley, University of WollongongFollow
Ruta Gupta, University of Sydney
Bruce Ashford, University of WollongongFollow
Joe Jabbour, University of Sydney
Jonathan Clark, Chris O'Brien LifehouseFollow

RIS ID

107483

Publication Details

Buckley, L., Gupta, R., Ashford, B., Jabbour, J. & Clark, J. R. (2016). Oropharyngeal cancer and human papilloma virus: evolving diagnostic and management paradigms. ANZ Journal of Surgery, 86 (6), 442-447.

Abstract

The significant increase in human papilloma virus (HPV)-associated oropharyngeal carcinoma (OPC) over recent years has lead to a surge in research and an improved understanding of the disease. Most patients with HPV-associated OPC present with cystic nodal metastases with a small primary tumour, and respond well to all treatment modalities including primary surgery and primary chemoradiotherapy. Current research is evaluating treatment de-escalation to reduce long-term treatment-associated morbidities. Transoral robotic surgery (TORS) is particularly relevant as the transoral approach allows small primary tumours to be removed with lower morbidity than traditional surgical approaches. The current American Joint Committee on Cancer staging system for oropharyngeal cancer does not appropriately stratify HPV-associated OPC; hence, alternative risk stratification and staging classifications are being proposed.