Human papillomavirus oropharynx carcinoma: Aggressive de‐escalation of adjuvant therapy

Head & Neck ◽  
2020 ◽  
Vol 43 (1) ◽  
pp. 229-237
Author(s):  
Eric J. Moore ◽  
Kathryn M. Van Abel ◽  
David M. Routman ◽  
Christine M. Lohse ◽  
Katharine A. R. Price ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Adjuvant Therapy ◽  
Oropharynx Carcinoma

Predicting Adverse Histopathology and Need for Postsurgical Adjuvant Therapy for Human Papilloma Virus–Associated Oropharynx Carcinoma

2021 ◽  
pp. 019459982098291
Author(s):  
Edgar Ochoa ◽  
Gaelen Stanford-Moore ◽  
Carole Fakhry ◽  
William R. Ryan
Keyword(s):  
Human Papillomavirus ◽  
Adjuvant Therapy ◽  
Predictive Value ◽  
Adjuvant Radiation ◽  
Nodal Staging ◽  
Seventh Edition ◽  
Extranodal Extension ◽  
American Joint Committee ◽  
Oropharynx Carcinoma ◽  
Definitive Surgery

Objective For human papillomavirus–associated oropharynx carcinoma treated with definitive surgery, we aimed to find predictors of adverse histopathology indicating the possible need for adjuvant therapy. Study Design Retrospective review. Setting National Cancer Database. Methods We analyzed 2347 eligible patients from 2010 to 2015. We evaluated (1) the ability of clinical nodal staging and extranodal extension designation per the AJCC, seventh edition (American Joint Committee on Cancer), to predict histopathology and (2) the likelihoods for adverse postsurgery histopathology by common clinical stages. Results Clinical nodal staging predicted pathologic nodal staging 65% of the time, with 24% (569/2347) being upstaged and 11% (251/2347) being downstaged. In patients with cN+ disease, clinical extranodal extension distinction had the following accuracy for pathologic extranodal extension: positive predictive value, 81% (88/109); negative predictive value, 73.1% (505/691); sensitivity, 32.1% (88/274); and specificity, 96.0% (505/526). Patients with cT1-2, N0-N2c, without clinical extranodal extension had the following proportions of pN2+ without pathologic extranodal extension (indicating consideration for adjuvant radiation): cN0, 11%; cN1, 31%; cN2a, 67% (8% downstaged); cN2b, 66% (6% downstaged); and cN2c, 35% (17% downstaged). From this group, patients had the following proportions of pathologic extranodal extension (indicating consideration for adjuvant chemoradiation): cN0, 6%; cN1, 20%; cN2a, 27%; cN2b, 28%; and cN2c, 48%. Conclusion For human papillomavirus–associated oropharynx carcinoma, nodal clinical staging per the American Joint Committee on Cancer, seventh edition, predicts pathologic stage about two-thirds of the time, leading to up- and downstaging. Clinical extranodal extension assessment has low sensitivity and moderate predictive capability. With careful selection, definitive surgery can allow patients to often avoid adjuvant chemotherapy and sometimes avoid adjuvant radiation.

scholarly journals HUMAN PAPILLOMAVIRUS AND ITS NATURE OF INFECTION: AN OVERVIEW

2018 ◽  
Vol 11 (6) ◽  
pp. 12
Author(s):  
Ranit Das ◽  
Vijay Mishra ◽  
Neha Sharma ◽  
Navneet Khurana
Keyword(s):  
Lung Cancer ◽  
Human Papillomavirus ◽  
Adjuvant Therapy ◽  
Head And Neck ◽  
Genomic Organization ◽  
Hpv Infection ◽  
Orphan Disease ◽  
Organization Mode ◽  
Mode Of Transmission ◽  
Modern Treatment

Human papillomavirus (HPV) belonging to Papillomaviridae (family of Papillomavirus). HPV infection causes various types of disorders and diseases including cervical, vaginal, anal, penile, oropharyngeal, and lung cancer also cancer in head and neck along with some malignant and benign warts. HPV also found to be responsible for respiratory papillomatosis. Epidermodysplasia verruciformis, an orphan disease termed as tree man disease, is also occurred by the HPV infection. Vaccines show benefit nowadays. Some surgery and adjuvant therapy is also showing response in the treatment of HPV caused cancers. In this abstract, we summarized the types, structures, genomic organization, mode of transmission of the virus along with type of infections, and protection and modern treatment approaches.

Rethinking the 10‐pack‐year rule for favorable human papillomavirus–associated oropharynx carcinoma: A multi‐institution analysis

Cancer ◽  
2020 ◽  
Vol 126 (12) ◽  
pp. 2784-2790
Author(s):  
James R. Broughman ◽  
David D. Xiong ◽  
Benjamin J. Moeller ◽  
Kevin J. Contrera ◽  
Brandon L. Prendes ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Oropharynx Carcinoma

Transoral Resection of Human Papillomavirus (HPV)-Positive Squamous Cell Carcinoma of the Oropharynx: Outcomes with and Without Adjuvant Therapy

2017 ◽  
Vol 24 (12) ◽  
pp. 3494-3501 ◽  
Author(s):  
Ryan S. Jackson ◽  
Parul Sinha ◽  
Joseph Zenga ◽  
Dorina Kallogjeri ◽  
Jasmina Suko ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Human Papillomavirus ◽  
Adjuvant Therapy ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Transoral Resection

Extracapsular spread and adjuvant therapy in human papillomavirus-related, p16-positive oropharyngeal carcinoma

Cancer ◽  
2011 ◽  
Vol 118 (14) ◽  
pp. 3519-3530 ◽  
Author(s):  
Parul Sinha ◽  
James S. Lewis ◽  
Jay F. Piccirillo ◽  
Dorina Kallogjeri ◽  
Bruce H. Haughey
Keyword(s):  
Human Papillomavirus ◽  
Adjuvant Therapy ◽  
Oropharyngeal Carcinoma ◽  
Extracapsular Spread
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