title: ACR Appropriateness Criteria(®) Locoregional therapy for resectable oropharyngeal squamous cell carcinomas.
abstract: There are no level I studies to guide treatment for resectable oropharyngeal squamous cell carcinoma (SCC). Treatment toxicities influence management recommendations. Ongoing investigations are examining deintensified treatments for human papillomavirus (HPV)-associated oropharyngeal SCC.
  
  
  
  The Appropriateness Criteria panel, using modified Delphi methodology, produced a literature summary, an assessment of treatment recommendations, and cases to illustrate their use.
  
  
  
  A multidisciplinary team produces optimum results. Based on HPV status, smoking history, and staging, patients are divided into groups at low, intermediate, and high-risk of death. In the future, treatment recommendations may be influenced by HPV status, which has changed the epidemiology of oropharyngeal SCC.
  
  
  
  T1 to T2N0M0 resectable oropharyngeal SCC can be treated with surgery or radiation without chemotherapy. Patients with T1-2N1-2aM0 disease can receive radiation, chemoradiation, or transoral surgery with neck dissection and appropriate adjuvant therapy. Patients with T1-2N2b-3M0 disease should receive chemoradiation or transoral surgery with neck dissection and appropriate adjuvant therapy. Concurrent chemoradiation is preferred for T3 to T4 disease. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1299-1309, 2016.
authors.affiliation: Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Jonathan J
authors.initials: JJ
authors.lastname: Beitler
authors.affiliation: Johns Hopkins University, Baltimore, Maryland.
authors.forename: Harry
authors.initials: H
authors.lastname: Quon
authors.affiliation: Radiological Associates of Sacramento, Sacramento, California.
authors.forename: Christopher U
authors.initials: CU
authors.lastname: Jones
authors.affiliation: Duke University Medical Center, Durham, North Carolina.
authors.forename: Joseph K
authors.initials: JK
authors.lastname: Salama
authors.affiliation: Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Busse
authors.affiliation: Maimonides Cancer Center, Brooklyn, New York.
authors.forename: Jay S
authors.initials: JS
authors.lastname: Cooper
authors.affiliation: Cleveland Clinic Foundation, Cleveland, Ohio.
authors.forename: Shlomo A
authors.initials: SA
authors.lastname: Koyfman
authors.affiliation: Fox Chase Cancer Center, Philadelphia, Pennsylvania, American College of Surgeons.
authors.forename: John A
authors.initials: JA
authors.lastname: Ridge
authors.affiliation: Emory University, Atlanta, Georgia, American Society of Clinical Oncology.
authors.forename: Nabil F
authors.initials: NF
authors.lastname: Saba
authors.affiliation: Henry Ford Hospital, Detroit, Michigan.
authors.forename: Farzan
authors.initials: F
authors.lastname: Siddiqui
authors.affiliation: Montefiore Medical Center, Bronx, New York, American College of Surgeons.
authors.forename: Richard V
authors.initials: RV
authors.lastname: Smith
authors.affiliation: University of Michigan, Ann Arbor, Michigan, American Society of Clinical Oncology.
authors.forename: Francis
authors.initials: F
authors.lastname: Worden
authors.affiliation: University Hospital Case Medical Center, Cleveland, Ohio.
authors.forename: Min
authors.initials: M
authors.lastname: Yao
authors.affiliation: University of California San Francisco, San Francisco, California.
authors.forename: Sue S
authors.identifier: 0000-0002-0779-7476
authors.initials: SS
authors.lastname: Yom
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000628:therapy* / Q000821:virology; D059248:Chemoradiotherapy / Q000379:methods; D003131:Combined Modality Therapy; D003697:Delphi Technique; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy* / Q000821:virology; D009960:Oropharynx / Q000601:surgery; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000453:epidemiology; D010611:Pharyngectomy / Q000379:methods; D017410:Practice Guidelines as Topic; D011379:Prognosis; D018570:Risk Assessment; D012955:Societies, Medical; D000077195:Squamous Cell Carcinoma of Head and Neck; D016019:Survival Analysis
keywords: base of tongue cancer; human papillomavirus (HPV); oropharyngeal cancer; tonsillar cancer; transoral robotic surgery (TORS)