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HNO Apr 2021Etiologically, oropharyngeal squamous cell carcinoma (OPSCC) can be divided into OPSCC caused by noxious agents and human papillomavirus (HPV)-driven carcinoma. These... (Review)
Review
BACKGROUND
Etiologically, oropharyngeal squamous cell carcinoma (OPSCC) can be divided into OPSCC caused by noxious agents and human papillomavirus (HPV)-driven carcinoma. These types differ with regard to clinical features and prognosis-differences which are rooted in the underlying molecular biology of the tumor.
OBJECTIVE
The aim of this work is to provide an overview of the molecular biological characteristics of the genetics, epigenetics, and immunology of OPSCC.
MATERIALS AND METHODS
A literature review was performed on a selection of genetic, epigenetic, and immunological factors characterizing OPSCC.
RESULTS
The understanding of genetic aberrations and their consequences for cancerogenesis and tumor biology is increasing. Epigenetic phenomena are complementing functional relationships. However, epigenetic mechanisms of gene regulation are complex and much research is still required in this field. Immunological aspects of cancer molecular biology have moved into the focus in light of recent advances in the field of immunotherapy.
CONCLUSION
The tumor biology of OPSCC is primarily defined by its HPV status. Additionally, HPV-independent genetic, epigenetic, and immunological signatures are being defined. From these advances, rationales for new treatment concepts may evolve.
Topics: Biology; Carcinoma, Squamous Cell; Head and Neck Neoplasms; Humans; Oropharyngeal Neoplasms; Papillomavirus Infections; Prognosis
PubMed: 33215226
DOI: 10.1007/s00106-020-00964-4 -
Nursing Sep 2023Approximately 1 in 60 men and 1 in 141 women will develop oral and oropharyngeal cancer in the US. This article presents the risk factors, pathogenesis, clinical... (Review)
Review
Approximately 1 in 60 men and 1 in 141 women will develop oral and oropharyngeal cancer in the US. This article presents the risk factors, pathogenesis, clinical presentation, and management of patients with oral and oropharyngeal squamous cell carcinoma.
Topics: Female; Humans; Male; Nurses; Oropharyngeal Neoplasms; Risk Factors
PubMed: 37616401
DOI: 10.1097/01.NURSE.0000946788.57053.35 -
Acta Otorrinolaringologica Espanola 2023To present the results of radiotherapy treatment in patients with oropharyngeal carcinomas.
OBJECTIVE
To present the results of radiotherapy treatment in patients with oropharyngeal carcinomas.
MATERIAL AND METHODS
Retrospective study of a cohort of 359 patients treated with radiotherapy, including chemo- and bio-radiotherapy, during the period 2000-2019. Information on human papillomavirus (HPV) status was available for 202 patients, of whom 26.2% were HPV-positive.
RESULTS
Five-year local recurrence-free survival was 73.5% (95% CI: 68.8%-78.2%). The variables that were related to local disease control in a multivariate study were the local tumor extension category and the HPV status. Five-year local recurrence-free survival for patients with cT1 tumors was 90.0%, for cT2 88.0%, for cT3 70.6%, and for cT4 42.3%. Five-year local recurrence-free survival for HPV-negative tumors was 67.2% and for HPV-positive tumors 93.3%. Five-year specific-disease survival was 64.4% (95% CI: 59.1%-69.7%). Variables that were related to specific survival in a multivariate study were the patient's general condition, local and regional extent of the tumor, and HPV status.
CONCLUSIONS
Five-year local recurrence-free survival of patients with oropharyngeal carcinomas treated with radiotherapy was 73.5%. Variables that were related to local control were local tumor extension and HPV status.
Topics: Humans; Retrospective Studies; Papillomavirus Infections; Carcinoma, Squamous Cell; Oropharyngeal Neoplasms; Papillomaviridae
PubMed: 37149134
DOI: 10.1016/j.otoeng.2023.05.001 -
Clinical Oral Investigations Dec 2023To conduct a systematic review to determine the global prevalence of HPV in oral squamous cell carcinoma (OSCC) and oropharyngeal squamous cell carcinoma (OPSCC). (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To conduct a systematic review to determine the global prevalence of HPV in oral squamous cell carcinoma (OSCC) and oropharyngeal squamous cell carcinoma (OPSCC).
MATERIALS AND METHODS
Literature was searched through October 2022 in main databases to address the question "What is the global prevalence of Human Papillomavirus in oral and oropharyngeal cancer?" Studies had to identify HPV by PCR, ISH, or p16 immunohistochemistry to be eligible. Quality was assessed using the JBI checklist for prevalence studies. Meta-analyses were performed, and reporting followed PRISMA guidelines.
RESULTS
Sixty-five studies were included, and most of them had methodological limitations related to sampling and the HPV detection tool. The pooled prevalence of HPV-positivity was 10% (event rate = 0.1; 95% CI: 0.07, 0.13; P < 0.01; I = 88%) in the oral cavity and 42% (event rate = 0.42; 95% CI: 0.36, 0.49; P = 0.02; I2 = 97%) in oropharynx. The highest HPV prevalence in OSCC was reached by Japan, meanwhile, in OPSCC, Finland and Sweden were the most prevalent. HPV16 is the genotype most frequent with 69% in OSCC and 89% in OPSCC, being the tonsils the intraoral location more affected by HPV (63%, p < 0.01, I 76%).
CONCLUSION
The evidence points to an apparent burden in HPV-related OPSCC, mostly in North America, Northern Europe, and Oceania, especially due to the HPV16 infection suggesting different trends across continents.
CLINICAL RELEVANCE
This updated systematic review and meta-analysis provide sufficient evidence about the global HPV prevalence in OSCC and OPSCC and the most frequent HPV subtype worldwide.
Topics: Humans; Squamous Cell Carcinoma of Head and Neck; Carcinoma, Squamous Cell; Human Papillomavirus Viruses; Papillomavirus Infections; Prevalence; Mouth Neoplasms; Oropharyngeal Neoplasms; Head and Neck Neoplasms
PubMed: 38158517
DOI: 10.1007/s00784-023-05425-0 -
Folia Medica Cracoviensia Oct 2023Our umbrella review aimed to summarize and revisit the evidence from all of the meta-analyses and systematic reviews regarding the treatments of oropharyngeal squamous... (Review)
Review
INTRODUCTION
Our umbrella review aimed to summarize and revisit the evidence from all of the meta-analyses and systematic reviews regarding the treatments of oropharyngeal squamous cell carcinoma (OPSCC).
MATERIALS AND METHODS
Major medical databases such as PubMed, Scopus, Embase, Web of Science, Google Scholar, Cochrane Library, BIOSIS, and EBSCO were searched. The overall search process was conducted in 3 stages.
RESULTS
Finally, a total of 28 studies met the inclusion criteria and were included in this study. Out of those 28 meta-analyses, a total of 315 primary studies were screened in order to extract the data and perform the statistical analysis. In total, data from 22,619 patients was analyzed.
CONCLUSION
The main objective of the present umbrella review was to summarize and analyze all of the evidence-based data provided by numerous meta-analyses and systematic reviews regarding the treatment of OPSCC. Our study delivers the most up-to-date and evidence-based results regarding the different therapeutic modalities of this malignancy in one concise review, making it the ultimate tool for physicians treating OPSCC.
Topics: Humans; Carcinoma, Squamous Cell; Oropharyngeal Neoplasms; Systematic Reviews as Topic; Meta-Analysis as Topic
PubMed: 38310532
DOI: 10.24425/fmc.2023.147217 -
Medicina Clinica Aug 2019Over the last few decades, the human papillomavirus (HPV) infection has emerged as a new epidemic and become a health issue due to its involvement in several cancers... (Review)
Review
Over the last few decades, the human papillomavirus (HPV) infection has emerged as a new epidemic and become a health issue due to its involvement in several cancers affecting the cervix, the anogenital region and the oropharynx. In this review, we aim to understand and explain the distinctive features of HPV-related oropharyngeal squamous cell carcinoma based on its epidemiological data, risk factors, specific topography, HPV subtypes most frequently involved, HPV-status diagnosis, clinical behaviour, prognosis, treatment, and preventive measures. In addition, the relationship of HPV with the development of other head and neck carcinomas and benign lesions of the oral cavity will also be discussed.
Topics: Carcinoma, Squamous Cell; Female; Head and Neck Neoplasms; Humans; Incidence; Male; Oropharyngeal Neoplasms; Papillomaviridae; Papillomavirus Infections; Prevalence; Risk Factors; Sex Factors; Spain
PubMed: 31109717
DOI: 10.1016/j.medcli.2019.02.027 -
Laryngo- Rhino- Otologie Oct 2021Oropharynx carcinoma (OPSCC) is a genetically heterogeneous tumor group with high prognostic diversity due to its worldwide increase in incidence and the association... (Review)
Review
BACKGROUND
Oropharynx carcinoma (OPSCC) is a genetically heterogeneous tumor group with high prognostic diversity due to its worldwide increase in incidence and the association with the human papillomavirus HPV 16, but also chronic tobacco/alcohol consumption.
OBJECTIVE
The review attempts to present the current view on therapy and prevention of OPSCC with respect to association with HPV 16.
MATERIAL & METHODS
The overview is based on the current relevant literature as well as current studies.
RESULTS & DISCUSSION
The OPSCC presents itself as a very complex, genetically heterogeneous group of head and neck tumors, which should therefore be considered in detail. The currently contradictory trial situation of retrospective studies versus prospective trials, the current TNM classification (8th edition) and the scarce prospective data arguing for non-inferiority of therapy de-intensification attempts currently admonish to encourage a more conservative treatment.
Topics: Carcinoma; Human papillomavirus 16; Humans; Oropharyngeal Neoplasms; Papillomavirus Infections; Prognosis; Prospective Studies; Retrospective Studies
PubMed: 34614529
DOI: 10.1055/a-1523-9045 -
PET Clinics Apr 2022Fluorine-18 fluorodeoxyglucose PET/computed tomography (F-FDG PET/CT) plays an important role in the staging, treatment planning, treatment response assessment,... (Review)
Review
Fluorine-18 fluorodeoxyglucose PET/computed tomography (F-FDG PET/CT) plays an important role in the staging, treatment planning, treatment response assessment, detecting recurrent disease, and predicting prognosis in patients with oral cavity and oropharyngeal squamous cell carcinoma. PET/CT has advantage especially in the detection of nodal, distant metastatic disease and second primary malignancy. PET/MR provides superior soft tissue contrast while decreasing radiation exposure, which is advantageous in evaluation of the primary tumor.
Topics: Fluorodeoxyglucose F18; Head and Neck Neoplasms; Humans; Mouth; Neoplasm Staging; Oropharyngeal Neoplasms; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Radiopharmaceuticals
PubMed: 35256303
DOI: 10.1016/j.cpet.2021.12.005 -
Radiotherapy and Oncology : Journal of... Jun 2023To answer an important question regarding the long-term morbidity of two oncological equivalent treatment for oropharyngeal squamous cell carcinoma (OPSCC), namely a... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND PURPOSE
To answer an important question regarding the long-term morbidity of two oncological equivalent treatment for oropharyngeal squamous cell carcinoma (OPSCC), namely a comparison of swallowing function results between patients treated with trans-oral robotic surgery (TORS) versus patients treated with radiotherapy (RT).
MATERIALS AND METHODS
Studies included patients with OPSCC treated with TORS or RT. Articles reporting complete data on MD Anderson Dysphagia Inventory (MDADI) and comparing the two treatments (TORS vs RT) were included in the meta-analysis. Swallowing assessed with MDADI was the primary outcome, the evaluation with instrumental methods was the secondary aim.
RESULTS
Included studies provided a total of 196 OPSCC primarily treated with TORS vs 283 OPSCC primarily treated with RT. The mean difference in MDADI score at the longest follow-up was not significantly different between TORS and RT group (mean difference [MD] -0.52; 95% CI -4.53-3.48; p = 0.80). After treatment, mean composite MDADI scores demonstrated a slight impairment in both groups without reaching a statistical difference compared to the baseline status. DIGEST score and Yale score showed a significantly worse function in both treatment groups at 12-month follow-up compared to baseline status.
CONCLUSION
The meta-analysis demonstrates that up-front TORS (+- adjuvant therapy) and up-front RT (+- CT) appear to be equivalent treatments in functional outcomes in T1-T2, N0-2 OPSCC, however, both treatments cause impaired swallowing ability. Clinicians should have a holistic approach and work with patients to develop an individualized nutrition plan and swallowing rehabilitation protocol from diagnosis to post-treatment surveillance.
Topics: Humans; Squamous Cell Carcinoma of Head and Neck; Deglutition; Oropharyngeal Neoplasms; Robotic Surgical Procedures; Head and Neck Neoplasms
PubMed: 36813176
DOI: 10.1016/j.radonc.2023.109547 -
Cancer Journal (Sudbury, Mass.)Human papillomavirus infection is currently implicated in the majority of oropharyngeal squamous cell carcinoma cases diagnosed in the United States. Circulating tumor... (Review)
Review
Human papillomavirus infection is currently implicated in the majority of oropharyngeal squamous cell carcinoma cases diagnosed in the United States. Circulating tumor DNA (ctDNA) has emerged as a potential biomarker for human papillomavirus-related oropharyngeal squamous cell carcinoma and has the opportunity to improve the diagnosis, treatment, and surveillance of patients with this disease. Changes in ctDNA levels during and after primary therapy may be related to disease response, which can possibly have implications for treatment intensification or de-escalation strategies. Further, ctDNA seems to be sensitive and specific for disease recurrence and may improve upon current methods for assessing both treatment response and failure. In this review, we examine the relevant literature on the use of ctDNA for oropharyngeal cancer treatment and surveillance and discuss current limitations and future directions for this promising biomarker.
Topics: Humans; Circulating Tumor DNA; Human Papillomavirus Viruses; Squamous Cell Carcinoma of Head and Neck; Neoplasm Recurrence, Local; Oropharyngeal Neoplasms; Papillomavirus Infections; Head and Neck Neoplasms; Biomarkers; Papillomaviridae
PubMed: 37471613
DOI: 10.1097/PPO.0000000000000667