Abstract
Simple SummaryContrary to other head and neck subsites, oropharyngeal squamous cell carcinoma (OPSCC) has shown a considerable increase in incidence over the past 20 years. This growing incidence is largely due to the increasing place of human papillomavirus (HPV)-related tumors. HPV-positive and HPV-negative OPSCC are two distinct entities with considerable differences in terms of treatment response and prognosis. However, there are no specific recommendations yet in the therapeutic management of OPSCC patients according to their tumor HPV-status. The aim of this review is therefore to discuss the therapeutic management of patients with OPSCC and the impact of HPV status on treatment selection.Since there is no published randomized study comparing surgical and non-surgical therapeutic strategies in patients with oropharyngeal squamous cell carcinoma (OPSCC), the therapeutic management of these patients remains highly controversial. While human papillomavirus (HPV)-positive and HPV-negative OPSCC are now recognized as two distinct diseases with different epidemiological, biological, and clinical characteristics, the impact of HPV status on the management of OPSCC patients is still unclear. In this review, we analyze the current therapeutic options in patients with OPSCC, highlighting the most recent advances in surgical and non-surgical therapies, and we discuss the impact of HPV status on the therapeutic strategy.
Highlights
Head and neck squamous cell carcinoma (HNSCC) accounts for more than 600,000 new cases each year worldwide and represents the 6th cause of cancer deaths [1,2,3]
Multicenter, non-inferiority trial of RT plus cetuximab or cisplatin in human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) (NRG Oncology RTOG 1016), Gillison et al found that cisplatin-based CRT was associated with higher overall survival (OS) rate
The role of tumor HPV-status on therapeutic decision-making in OPSCC patients is not yet well defined
Summary
Head and neck squamous cell carcinoma (HNSCC) accounts for more than 600,000 new cases each year worldwide and represents the 6th cause of cancer deaths [1,2,3]. It is widely acknowledged that the therapeutic decision has to be made by a tumor board, where the cases of individual cancer patients are thoroughly reviewed by a team of physicians and other health professionals from different specialties (surgeons, medical and radiation oncologists, radiologists, and pathologists) This results in great variability in the therapeutic management of patients with OPSCC between medical teams, according to their particular experience and skills [11]. The development of minimally-invasive surgical procedures and the progress in microvascular reconstructive surgery have considerably reduced the classic sequelae of oropharyngeal oncologic surgery [16,17] These data explain why the role of upfront surgery and the impact of tumor HPV status in the initial management of OPSCC remain largely debated. The aim of this review article is to discuss current therapeutic strategies in patients with OPSCC and the potential impact of tumor HPV status
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