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The changing landscape of oropharyngeal cancer management

  • D Hamilton (a1), M K Khan (a1), J O'hara (a1) and V Paleri (a1)

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.

Method:

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.

Conclusion:

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.

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Copyright

Corresponding author

Address for correspondence: Mr David Hamilton, ENT Department, Freeman Hospital, High Heaton, Newcastle upon Tyne NE7 7DN, UK E-mail: david.hamilton@ncl.ac.uk

References

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1 Cancer Research UK. Oral cancer incidence statistics, 2013. In: http://info.cancerresearchuk.org/cancerstats/types/oral/incidence [27 September 2016]
2 National Cancer Institute. Surveillance, Epidemiology and End Results Program, 2013. In: http://seer.cancer.gov/ [27 September 2016]
3 Nasman, A, Attner, P, Hammarstedt, L, Du, J, Eriksson, M, Giraud, G et al. Incidence of human papillomavirus (HPV) positive tonsillar carcinoma in Stockholm, Sweden: an epidemic of viral-induced carcinoma? Int J Cancer 2009;125:362–6
4 Fakhry, C, Westra, WH, Li, S, Cmelak, A, Ridge, JA, Pinto, H et al. Improved survival of patients with human papillomavirus-positive head and neck squamous cell carcinoma in a prospective clinical trial. J Natl Cancer Inst 2008;100:261–9
5 Worden, FP, Kumar, B, Lee, JS, Wolf, GT, Cordell, KG, Taylor, JM et al. Chemoselection as a strategy for organ preservation in advanced oropharynx cancer: response and survival positively associated with HPV16 copy number. J Clin Oncol 2008;26:3138–46
6 Ang, KK, Harris, J, Wheeler, R, Weber, R, Rosenthal, DI, Nguyen-Tan, PF et al. Human papillomavirus and survival of patients with oropharyngeal cancer. N Engl J Med 2010;363:2435
7 Gillison, ML, Zhang, Q, Jordan, R, Xiao, W, Westra, WH, Trotti, A et al. Tobacco smoking and increased risk of death and progression for patients with p16-positive and p16-negative oropharyngeal cancer. J Clin Oncol 2012;30:2102–11
8 Heck, JE, Berthiller, J, Vaccarella, S, Winn, DM, Smith, EM, Shan'gina, O et al. Sexual behaviours and the risk of head and neck cancers: a pooled analysis in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. Int J Epidemiol 2010;39:166–81
9 Mehanna, H, Jones, TM, Gregoire, V, Ang, KK. Oropharyngeal carcinoma related to human papillomavirus. BMJ 2010;340:c1439
10 Singhi, AD, Westra, WH. Comparison of human papillomavirus in situ hybridization and p16 immunohistochemistry in the detection of human papillomavirus-associated head and neck cancer based on a prospective clinical experience. Cancer 2010;116:2166–73
11 O'Sullivan, B, Huang, SH, Siu, LL, Waldron, J, Zhao, H, Perez-Ordonez, B et al. Deintensification candidate subgroups in human papillomavirus-related oropharyngeal cancer according to minimal risk of distant metastasis. J Clin Oncol 2013;31:543–50
12 Granata, R, Miceli, R, Orlandi, E, Perrone, F, Cortelazzi, B, Franceschini, M et al. Tumor stage, human papillomavirus and smoking status affect the survival of patients with oropharyngeal cancer: an Italian validation study. Ann Oncol 2012;23:1832–7
13 Parsons, JT, Mendenhall, WM, Stringer, SP, Amdur, RJ, Hinerman, RW, Villaret, DB et al. Squamous cell carcinoma of the oropharynx: surgery, radiation therapy, or both. Cancer 2002;94:2967–80
14 Denis, F, Garaud, P, Bardet, E, Alfonsi, M, Sire, C, Germain, T et al. Final results of the 94–01 French Head and Neck Oncology and Radiotherapy Group randomized trial comparing radiotherapy alone with concomitant radiochemotherapy in advanced-stage oropharynx carcinoma. J Clin Oncol 2004;22:6976
15 Abendstein, H, Nordgren, M, Boysen, M, Jannert, M, Silander, E, Ahlner-Elmqvist, M et al. Quality of life and head and neck cancer: a 5 year prospective study. Laryngoscope 2005;115:2183–92
16 Rogers, SN, Ahad, SA, Murphy, AP. A structured review and theme analysis of papers published on ‘quality of life’ in head and neck cancer: 2000–2005. Oral Oncol 2007;43:843–68
17 Denis, F, Garaud, P, Bardet, E, Alfonsi, M, Sire, C, Germain, T et al. Late toxicity results of the GORTEC 94–01 randomized trial comparing radiotherapy with concomitant radiochemotherapy for advanced-stage oropharynx carcinoma: comparison of LENT/SOMA, RTOG/EORTC, and NCI-CTC scoring systems. Int J Radiat Oncol Biol Phys 2003;55:93–8
18 Wilson, JA, Carding, PN, Patterson, JM. Dysphagia after nonsurgical head and neck cancer treatment: patients' perspectives. Otolaryngol Head Neck Surg 2011;145:767–71
19 Paleri, V, Patterson, J. Use of gastrostomy in head and neck cancer: a systematic review to identify areas for future research. Clin Otolaryngol 2010;35:177–89
20 Moor, JW, Patterson, J, Kelly, C, Paleri, V. Prophylactic gastrostomy before chemoradiation in advanced head and neck cancer: a multiprofessional web-based survey to identify current practice and to analyse decision making. Clin Oncol (R Coll Radiol) 2010;22:192–8
21 Nutting, CM, Morden, JP, Harrington, KJ, Urbano, TG, Bhide, SA, Clark, C et al. Parotid-sparing intensity modulated versus conventional radiotherapy in head and neck cancer (PARSPORT): a phase 3 multicentre randomised controlled trial. Lancet Oncol 2011;12:127–36
22 Forastiere, AA, Goepfert, H, Maor, M, Pajak, TF, Weber, R, Morrison, W et al. Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. N Engl J Med 2003;349:2091–8
23 Trotti, A, Pajak, TF, Gwede, CK, Paulus, R, Cooper, J, Forastiere, A et al. TAME: development of a new method for summarising adverse events of cancer treatment by the Radiation Therapy Oncology Group. Lancet Oncol 2007;8:613–24
24 Huet, PC. Electrocoagulation in epitheliomas of the tonsils. Ann Otolaryngol 1951;68:433–42
25 Holsinger, FC, McWhorter, AJ, Ménard, M, Garcia, D, Laccourreye, O. Transoral lateral oropharyngectomy for squamous cell carcinoma of the tonsillar region: I. Technique, complications, and functional results. Arch Otolaryngol Head Neck Surg 2005;131:583–91
26 Laccourreye, O, Hans, S, Ménard, M, Garcia, D, Brasnu, D, Holsinger, FC. Transoral lateral oropharyngectomy for squamous cell carcinoma of the tonsillar region: II. An analysis of the incidence, related variables, and consequences of local recurrence. Arch Otolaryngol Head Neck Surg 2005;131:592–9.
27 Steiner, W, Fierek, O, Ambrosch, P, Hommerich, CP, Kron, M. Transoral laser microsurgery for squamous cell carcinoma of the base of the tongue. Arch Otolaryngol Head Neck Surg 2003;129:3643
28 Haughey, BH, Hinni, ML, Salassa, JR, Hayden, RE, Grant, DG, Rich, JT et al. Transoral laser microsurgery as primary treatment for advanced-stage oropharyngeal cancer: a United States multicenter study. Head Neck 2011;33:1683–94
29 O'Hara, J, Cosway, B, Muirhead, C, Leonard, N, Goff, D, Patterson, J. Transoral laser microsurgery ± adjuvant therapy versus chemoradiotherapy for stage III and IVA oropharyngeal squamous cell cancer: preliminary comparison of early swallowing outcomes. Head Neck 2015;37:1488–94
30 Hockstein, NG, Nolan, JP, O'Malley, BW Jr, Woo, YJ. Robotic microlaryngeal surgery: a technical feasibility study using the daVinci surgical robot and an airway mannequin. Laryngoscope 2005;115:780–5
31 O'Malley, BW Jr, Weinstein, GS, Hockstein, NG. Transoral robotic surgery (TORS): glottic microsurgery in a canine model. J Voice 2006;20:263–8
32 O'Malley, BW Jr, Weinstein, GS, Snyder, W, Hockstein, NG. Transoral robotic surgery (TORS) for base of tongue neoplasms. Laryngoscope 2006;116:1465–72
33 Weinstein, GS, O'Malley, BW Jr, Snyder, W, Sherman, E, Quon, H. Transoral robotic surgery: radical tonsillectomy. Arch Otolaryngol Head Neck Surg 2007;133:1220–6
34 White, HN, Moore, EJ, Rosenthal, EL, Carroll, WR, Olsen, KD, Desmond, RA et al. Transoral robotic-assisted surgery for head and neck squamous cell carcinoma: one- and 2-year survival analysis. Arch Otolaryngol Head Neck Surg 2010;136:1248–52
35 Weinstein, GS, O'Malley, BW Jr, Magnuson, JS, Carroll, WR, Olsen, KD, Daio, L et al. Transoral robotic surgery: a multicenter study to assess feasibility, safety, and surgical margins. Laryngoscope 2012;122:1701–7
36 Cooper, JS, Pajak, TF, Forastiere, AA, Jacobs, J, Campbell, BH, Saxman, SB et al. Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med 2004;350:1937–44

Keywords

The changing landscape of oropharyngeal cancer management

  • D Hamilton (a1), M K Khan (a1), J O'hara (a1) and V Paleri (a1)

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