Staging of human papilloma virus related cancers of the oropharynx

Abstract

For the past two decades an increasing number of oropharyngeal cancers have been found to be associated with the human papilloma virus (HPV). These tumors are a biologically distinct entity with better prognosis and excellent response to therapy. Therefore, a separate staging system has been introduced for HPV‐related oropharyngeal tumors in the latest edition of the American Joint Committee on Cancer (AJCC eighth Ed).

The discordant biomarker dilemma: What are the diagnostic implications of oropharyngeal squamous cell carcinomas with discrepant p16 and HPV results?

“…High‐risk human papillomavirus (HPV)‐associated oropharyngeal squamous cell carcinoma (OPSCC) exhibits distinctive clinical, pathologic, epidemiologic, and prognostic features 1 . Because of the better treatment response and survival profiles associated with HPV‐associated versus HPV‐independent OPSCC, the American Joint Committee on Cancer and Union for International Cancer Control staging systems currently risk stratify OPSCC differently, depending on high‐risk HPV (HR‐HPV) status 2–7 . Selected patients with HPV‐mediated OPSCC may be eligible for clinical trials investigating less intensive treatment regimens relative to standard‐of‐care surgery, radiotherapy, and/or chemotherapy protocols 8–10 .…”

“…1 Because of the better treatment response and survival profiles associated with HPV-associated versus HPV-independent OPSCC, the American Joint Committee on Cancer and Union for International Cancer Control staging systems currently risk stratify OPSCC differently, depending on high-risk HPV (HR-HPV) status. [2][3][4][5][6][7] Selected patients with HPV-mediated OPSCC may be eligible for clinical trials investigating less intensive treatment regimens relative to standardof-care surgery, radiotherapy, and/or chemotherapy protocols. 8-10 Therefore, HR-HPV status should be determined on the primary tumor or regional lymph node metastasis of all newly diagnosed OPSCC.…”