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Oropharyngeal cancer and human papilloma virus: evolving diagnostic and management paradigms
Author(s) -
Buckley Lisa,
Gupta Ruta,
Ashford Bruce,
Jabbour Joe,
Clark Jonathan R.
Publication year - 2016
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.13417
Subject(s) - medicine , human papilloma virus , cancer , chemoradiotherapy , transoral robotic surgery , disease , oncology , intensive care medicine , surgery , cervical cancer
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.