title: Oropharyngeal cancer and human papilloma virus: evolving diagnostic and management paradigms.
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.
authors.affiliation: Graduate School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Buckley
authors.affiliation: Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia.|Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
authors.forename: Ruta
authors.initials: R
authors.lastname: Gupta
authors.affiliation: Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia.
authors.forename: Bruce
authors.initials: B
authors.lastname: Ashford
authors.affiliation: Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Joe
authors.initials: J
authors.lastname: Jabbour
authors.affiliation: Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia.|Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.|South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Clark
mesh_terms: D002294:Carcinoma, Squamous Cell; D003131:Combined Modality Therapy; D004279:DNA, Viral / Q000032:analysis*; D003952:Diagnostic Imaging / Q000379:methods*; D019468:Disease Management; D006801:Humans; D009959:Oropharyngeal Neoplasms / Q000175:diagnosis / Q000628:therapy / Q000821:virology; D027383:Papillomaviridae / Q000235:genetics*; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000628:therapy / Q000821:virology
chemical_list: D004279:DNA, Viral
keywords: human papilloma virus; oropharyngeal cancer; p16; robotic surgical procedures; transmission