Surgical Management of Oropharyngeal Squamous Cell Carcinoma

Abstract

Squamous cell carcinoma of the oropharynx (OPSCC) occurs with an age-adjusted incidence rate of 2.2/100,000 per year, and makes up one of the largest growing subsets of head and neck cancer. Traditional risk factors include alcohol and tobacco exposure, however, the demographics have changed significantly over the past 2–3 decades, with human papillomavirus (HPV) infection now considered one of the most important risk factors. As our understanding of HPV-related OPSCC has developed, there has been increasing evidence that this new tumor subtype has a better overall prognosis and response to therapies. This review focuses on OPSCC from a surgical perspective. We review the relevant anatomy, diagnosis and workup, and discuss several different surgical approaches for management of this disease, including transoral robotic surgery, lateral oropharyngectomy and tonsillectomy, base of tongue resection, and neck dissection. In addition, the common complications associated with these treatment options are discussed.