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

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Abstract

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.

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Authors and Affiliations

  1. Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA

    Stuart E. Samuels & Avraham Eisbruch

  2. Departments of Radiation Oncology, Otolaryngology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA

    Jonathan J. Beitler

  3. Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia

    June Corry

  4. Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI, USA

    Carol R. Bradford

  5. Department of Hematology and Medical Oncology, The Winship Cancer Institute of Emory University, Atlanta, GA, USA

    Nabil F. Saba

  6. Department of Head and Neck Surgery and Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands

    Michiel W. M. van den Brekel

  7. Department of Radiation Oncology, The Prince of Wales Cancer Centre, Sydney, NSW, Australia

    Robert Smee

  8. Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia

    Primož Strojan

  9. Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain

    Carlos Suárez & Juan P. Rodrigo

  10. Instituto Universitario de Oncología del Principado de Asturias, Universidad de Oviedo, Oviedo, Spain

    Carlos Suárez & Juan P. Rodrigo

  11. Department of Radiation Oncology, University of Florida, Gainesville, FL, USA

    William M. Mendenhall

  12. Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands

    Robert P. Takes

  13. Division of Oncology, Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA

    Missak Haigentz Jr.

  14. Department of Head and Neck Surgery, Greek Anticancer Institute, Saint Savvas Hospital, Athens, Greece

    Alexander D. Rapidis

  15. University of Udine School of Medicine, Udine, Italy

    Alessandra Rinaldo

  16. Coordinator of the International Head and Neck Scientific Group, Padua, Italy

    Alfio Ferlito

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  1. Stuart E. Samuels
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Correspondence to Alfio Ferlito.

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This article was written by members and invitees of the International Head and Neck Scientific Group (http://www.IHNSG.com).

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Samuels, S.E., Eisbruch, A., Beitler, J.J. et al. Management of locally advanced HPV-related oropharyngeal squamous cell carcinoma: where are we?. Eur Arch Otorhinolaryngol 273, 2877–2894 (2016). https://doi.org/10.1007/s00405-015-3771-x

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