title: The changing landscape of oropharyngeal cancer management.
abstract: BACKGROUND
  Oropharyngeal cancer is increasing in prevalence in the UK and this is thought to be due to the emergence of disease related to human papilloma virus.
  
  
  METHODS
  A literature review was conducted on the diagnosis and latest management of oropharyngeal cancer.
  
  
  RESULTS
  In non-smokers, human papilloma virus related disease is thought to have better outcomes, but this casts doubt on previous research which did not stratify patients according to human papilloma virus status. However, this theory provides a route for researchers to risk stratify and de-escalate treatments, and hence reduce treatment burden. In addition, the emergence of minimally invasive transoral techniques allows surgeons to remove large tumours without many of the side effects associated with radical (chemo)radiotherapy.
  
  
  CONCLUSIONS
  The emergence of human papilloma virus related disease and minimally invasive techniques have led the clinical and academic community to reconsider how oropharyngeal cancer is managed. Comparative and risk-stratification trials are urgently required and ongoing.
authors.affiliation: ENT Department,Freeman Hospital,Newcastle upon Tyne,UK.
authors.forename: D
authors.initials: D
authors.lastname: Hamilton
authors.affiliation: ENT Department,Freeman Hospital,Newcastle upon Tyne,UK.
authors.forename: M K
authors.initials: MK
authors.lastname: Khan
authors.affiliation: ENT Department,Freeman Hospital,Newcastle upon Tyne,UK.
authors.forename: J
authors.initials: J
authors.lastname: O'hara
authors.affiliation: ENT Department,Freeman Hospital,Newcastle upon Tyne,UK.
authors.forename: V
authors.initials: V
authors.lastname: Paleri
mesh_terms: D006801:Humans; D009959:Oropharyngeal Neoplasms / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy / Q000821:virology; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000150:complications / Q000175:diagnosis
keywords:  Operative; Human Papilloma Virus; Laser Therapy; Oropharyngeal Neoplasms; Robotic Surgical Procedures; Surgical Procedures