TY - JOUR
T1 - The "new" head and neck cancer patient - Young, nonsmoker, nondrinker, and HPV positive
T2 - Evaluation
AU - Deschler, Daniel G.
AU - Richmon, Jeremy D.
AU - Khariwala, Samir S.
AU - Ferris, Robert L.
AU - Wang, Marilene B.
PY - 2014/9
Y1 - 2014/9
N2 - Objective. The near epidemic rise of the incidence of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinomas (OPSCC) presents the practitioner with a "new" head and neck cancer patient, vastly different from those with the traditional risk factors who formed the basis of most practitioners' training experience. Accordingly, a thorough and disease-specific evaluation process is necessitated. This article will review the evaluation of the HPV-related cancer patient, including a review of the HPV-positive oropharyngeal cancer epidemic from the surgeon's perspective, evaluation of the primary lesion, evaluation of the neck mass, and role of imaging, to provide a framework for addressing the challenging questions patients may ask. Data Sources. Available peer-reviewed literature and practice guidelines. Review Methods. Assessment of selected specific topics by authors solicited from the Head and Neck Surgery and Oncology Committee of the American Academy of Otolaryngology-Head and Neck Surgery Foundation and the American Head and Neck Society. Conclusions and Implications for Practice. The dramatic rise in OPSSC related to HPV is characterized by a "new" cancer patient who is younger and lacks traditional risk factors. Today's caregiver must be prepared to appropriately evaluate, counsel, and treat these patients with HPV-positive disease with the expectation that traditional treatment algorithms will evolve to maintain or improve current excellent cure rates while lessening treatment related side effects.
AB - Objective. The near epidemic rise of the incidence of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinomas (OPSCC) presents the practitioner with a "new" head and neck cancer patient, vastly different from those with the traditional risk factors who formed the basis of most practitioners' training experience. Accordingly, a thorough and disease-specific evaluation process is necessitated. This article will review the evaluation of the HPV-related cancer patient, including a review of the HPV-positive oropharyngeal cancer epidemic from the surgeon's perspective, evaluation of the primary lesion, evaluation of the neck mass, and role of imaging, to provide a framework for addressing the challenging questions patients may ask. Data Sources. Available peer-reviewed literature and practice guidelines. Review Methods. Assessment of selected specific topics by authors solicited from the Head and Neck Surgery and Oncology Committee of the American Academy of Otolaryngology-Head and Neck Surgery Foundation and the American Head and Neck Society. Conclusions and Implications for Practice. The dramatic rise in OPSSC related to HPV is characterized by a "new" cancer patient who is younger and lacks traditional risk factors. Today's caregiver must be prepared to appropriately evaluate, counsel, and treat these patients with HPV-positive disease with the expectation that traditional treatment algorithms will evolve to maintain or improve current excellent cure rates while lessening treatment related side effects.
KW - human papillomavirus (HPV)
KW - management neck mass
KW - oropharyngeal cancer
KW - unknown primary
UR - http://www.scopus.com/inward/record.url?scp=84908281572&partnerID=8YFLogxK
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U2 - 10.1177/0194599814538605
DO - 10.1177/0194599814538605
M3 - Review article
C2 - 24925311
AN - SCOPUS:84908281572
SN - 0194-5998
VL - 151
SP - 375
EP - 380
JO - Otolaryngology - Head and Neck Surgery (United States)
JF - Otolaryngology - Head and Neck Surgery (United States)
IS - 3
ER -