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6.9.6: 6. HPV-Related Oropharyngeal Cancer

  • Page ID
    53883
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    HPV-related Oropharyngeal cancer

    • HPV 16 & 18 are associated with oropharyngeal cancer
    • Sexually transmitted
    • Mostly non-smoking, healthy young adults, more common males
    • P16 is a surrogate marker for HPV (sensitivity 100%, has false +ves)
    • May present with a small primary and large, often cystic, cervical metastases
    • HPV status has prognostic value
      • Different biological behaviour from tobacco-induced oropharyngeal cancer
      • Better prognosis, even with advanced-stage disease
      • Volume and extent of nodal metastases do not have same negative impact on outcome
      • HPV + patients with a significant smoking history probably have same prognosis as HPV –
      • Prognostic value of p16 status may not apply to suboptimally treated patients in resource constrained settings
    • Affects staging
      • Different N-staging for HPV+ vs HPV-
      • Same T-staging for HPV+ and HPV-
      • Stage IV only assigned to patients with distant metastases
    • HPV status does not influence choice of primary treatment at this time