Postoperative Treatment of Oropharyngeal Cancer in the Era of Human Papillomavirus

  • Jessica L. GeigerEmail author
  • Jamie A. Ku
Head and Neck Cancer (CP Rodriguez, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Head and Neck Cancer

Opinion statement

Despite an overall decline in the incidence of tobacco-related cancers, human papillomavirus (HPV)–related head and neck squamous cell carcinoma (HNSCC) of the oropharynx is on the rise. The prognosis of HPV-related oropharynx cancer (HPV-OPC) is generally favorable even in locoregionally advanced disease, and a variety of treatment options are available. Though the primary treatment modality of choice remains definitive radiation (RT), surgical resection followed by appropriate adjuvant therapy remains an option, especially in those patients who may not be favorable candidates for definitive radiotherapy, particularly when concurrent chemotherapy is warranted. Upfront resection may offer a chance to avoid the well-described acute toxicity and long-term morbidity associated with concurrent chemoradiotherapy (CRT) in select patients. Despite the overall favorable prognosis of HPV-OPC, indications for therapy remain unchanged from the recommendations for treatment in tobacco-related OPC and other anatomic sites of HNSCC. Ongoing studies assessing deintensification strategies in HPV-OPC are focused on maintaining high cure rates while improving treatment-related toxicities. Currently, no clear guidelines exist for the choice of primary therapy, surgical resection, or RT in patients with HPV-OPC, highlighting the need for multidisciplinary discussion and review of the individual patient before selecting the most appropriate curative modality. This review seeks to present the data for postoperative therapy in HPV-related oropharyngeal HNSCC.


Head and neck cancer Oropharyngeal cancer Human papillomavirus Squamous cell carcinoma of the head and neck 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Hematology and Medical Oncology, Taussig Cancer InstituteCleveland ClinicClevelandUSA
  2. 2.Department of Head and Neck Oncologic Surgery, Head and Neck InstituteCleveland ClinicClevelandUSA
  3. 3.Department of Facial Plastic & Microvascular Surgery, Head and Neck InstituteCleveland ClinicClevelandUSA

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