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

Current Opinion in Otolaryngology & Head and Neck Surgery
Hisham MehannaL Licitra

Abstract

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. 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. 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 ...Continue Reading

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Citations

Jan 16, 2014·Indian Journal of Surgical Oncology·Vijayalakshmi Ramshankar, Arvind Krishnamurthy
Nov 20, 2013·Journal of Otolaryngology - Head & Neck Surgery = Le Journal D'oto-rhino-laryngologie Et De Chirurgie Cervico-faciale·Margo RiouxEdward Reardon
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Oct 30, 2016·Journal of Otolaryngology - Head & Neck Surgery = Le Journal D'oto-rhino-laryngologie Et De Chirurgie Cervico-faciale·Sherif IdrisVincent L Biron
Mar 3, 2017·Current Opinion in Oncology·Fernando L DiasFernando Danelon Leonhardt
Mar 13, 2017·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Ali QureishiStuart Winter
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Jul 14, 2019·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Reut Aviv MordechaiOhad Ronen
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Mar 20, 2014·Chemical Research in Toxicology·Andrew P SteinPaul F Lambert

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