HPV, Is It in Your DNA? Head and Neck Cancer Updates for the General Otolaryngologist (2022 AMW) Front Matter
2022 AAO-HNSF Annual Meeting & OTO Experience
With the increasing use of transoral robotic surgery, p16+ (HPV+) oropharynx squamous cell carcinoma is increasingly being managed surgically. However, the widespread adoption of TORS does not relinquish the general otolaryngologist or head and neck surgeon from following evidence-based medicine and demands even greater attention to disease attributes, institutional capabilities, and patient goals. Importantly, a clear understanding of the role for adjuvant therapy in the context of a more surgically focused management paradigm is critical to improve communication with patients and set appropriate expectations. This multi-disciplinary panel will discuss a surgically focused approach to HPV+ OPSCC, including treatment options for HPV+ OPSCC as well as criteria for identifying ideal surgical candidates. Discussion will be presented in a tumor-board style, and when applicable, include images and videos from surgical cases performed. An emphasis will be placed on evidence and previously published studies, as well as ongoing clinical trials (e.g. ECOG 3311). Our discussion will importantly extend to our institutional focus on surgical management and the rationale and patient management considerations that accompany this approach. In particular, we will focus on the options for adjuvant therapy and factors that determine the sites and dosage of radiation received. This important topic will be approached through case-based discussion including live poling of the audience to help shed insight into state of the art practice patterns, while incorporating the input of experts in head and neck oncology.