Oropharyngeal cancer - Is it time to change management according to human papilloma virus status?

Hisham Mehanna, Oladejo Olaleye, Lisa Licitra

Research output: Contribution to journalArticlepeer-review

Abstract

PURPOSE OF REVIEW: There is currently strong evidence supporting human papilloma virus (HPV) causation in a distinct disease entity of oropharyngeal cancer (OPC), with an increasing incidence worldwide.This review aims to critically analyse whether a change in our management approaches to HPV-positive OPC is now required for this increasingly significant public health concern. RECENT FINDINGS: HPV-positive OPC appears to have increased worldwide. HPV status has a strong prognostic effect, and, in combination with smoking status, primary, and nodal stage, is useful in the risk stratification of OPC. HPV-positive OPC responds better to chemoradiotherapy, surgery, and postoperative chemoradiotherapy than HPV-negative tumours, with improved survival outcomes. There remain concerns regarding the efficacy of HPV detection assays in clinical practice. HPV-negative head and neck cancer still accounts for the largest subset of patients that we treat and carries poor survival outcomes. SUMMARY: It is currently not advisable to change management for either HPV-positive or HPV-negative OPC as there is a lack of high-quality evidence to support this. High-quality randomized controlled trials are required to assess the efficacy of the different treatment modalities currently available for both HPV-positive and HPV-negative OPC.

Original languageEnglish
JournalCurrent Opinion in Otolaryngology and Head and Neck Surgery
Volume20
Issue number2
DOIs
Publication statusPublished - Apr 2012

Keywords

  • human papilloma virus
  • oropharyngeal cancer
  • tongue base
  • tonsil

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Surgery

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