Abstract
The oropharynx has become the leading primary site for Human Papilloma Virus (HPV)-associated head and neck cancer. HPV positive oropharyngeal squamous cell carcinoma (HPV+ OSCC) has emerged as an epidemic not easily recognized by many physicians, resulting in delays in diagnosis and management. HPV+ OSCC traditionally refers to younger, healthier patients with high economic status and high-risk sexual behavior and is related to improved prognosis. De-intensification strategies are being evaluated in ongoing clinical trials and if validated, might help spare severe morbidity associated with current cisplatin-based chemoradiotherapy, which is the standard of care for all patients with locally advanced head and neck cancer. On the other hand, whether HPV status represents an important prognostic factor for non-oropharyngeal sites remains to be elucidated.
Highlights
High-risk Human Papillomaviruses (HPVs) are associated with the development of premalignant lesions and certain cancers due to their high oncogenic potential
Current data are insufficient to suggest changes in management of HPV+ oropharyngeal squamous cell carcinoma (OSCC), evaluation of HPV status has been incorporated in treatment guidelines worldwide due to a major impact in prognosis which is reflected on the new Tumor Node Metastasis (TNM) staging for HPV+ disease [3]
The majority of HPV+ cases are attributed to high-risk HPV16 subtype
Summary
High-risk Human Papillomaviruses (HPVs) are associated with the development of premalignant lesions and certain cancers due to their high oncogenic potential. HPV currently accounts for the majority of patients with primary oropharyngeal squamous cell carcinoma (OSCC), taking precedence over traditional etiological factors, such as smoking and alcohol [1]. HPV positive OSCC (HPV+ OSCC) comprises a distinct disease entity, with a different clinical and biological behavior [2]. Current data are insufficient to suggest changes in management of HPV+ OSCC, evaluation of HPV status has been incorporated in treatment guidelines worldwide due to a major impact in prognosis which is reflected on the new Tumor Node Metastasis (TNM) staging for HPV+ disease [3]. We will discuss the utility of assessing HPV status as a clinically relevant biomarker in HPV-associated non-oropharyngeal head and neck squamous cell carcinoma (HNSCC)
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