The current epidemic of HPV-associated oropharyngeal cancer: An 18-year Danish population-based study with 2,169 patients

Garset‐Zamani, Martin; Grønhøj, Christian; Jensen, David Hebbelstrup; Carlander, A.; Agander, Tina Klitmøller; Kiss, Katalin; Olsen, Caroline Holkmann; Baandrup, Louise; Nielsen, Finn Cilius; Andersen, Elo; Friborg, Jeppe; Buchwald, Christian von

doi:10.1016/j.ejca.2020.04.027

Cited by 82 publications

(109 citation statements)

References 20 publications

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“…The incidence of oropharyngeal cancers, including oropharyngeal squamous cell carcinomas (OPSCC), is increasing mainly due to a sharp increase in HPV positive cancers in many countries 1,2 . With a majority of OPSCC being HPV positive and, as HPV‐positive OPSCC has a better prognosis, more patients become long‐term cancer survivors, living with chronic adverse treatment side‐effects.…”

Section: Introductionmentioning

confidence: 99%

Long‐term quality of life & functional outcomes after treatment of oropharyngeal cancer

et al. 2020

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Functional and QoL outcomes were compared longitudinally in a cohort of patients treated for oropharyngeal squamous cell carcinoma (OPSCC) with primary transoral robotic surgery (TORS) or radiotherapy (RT). Forty‐four patients undergoing primary TORS (n = 31) or RT (n = 13) for any stage OPSCC were included. Only low‐stage disease was treated with TORS. Functional outcomes were: salivary flow rate, image‐based swallowing function, and a self‐reported 10‐point scale comparing current swallowing function to baseline (CvB scale). QoL was assessed with European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core (EORTC QLQ‐C30), Head & Neck Module (EORTC QLQ‐HN35), and MD Anderson Dysphagia Inventory (MDADI). Shoulder impairment was assessed with Neck Dissection Impairment Index (NDII) and Oxford Shoulder Score (OSS). In the RT group, salivary flow rates had significantly declined at 12‐month follow‐up, with the biggest declines in QoL subscale scores recorded in the RT group for dry mouth and sticky saliva. Swallowing function on imaging studies was overall good, with no severe dysphagia within 1 year although, both treatment groups showed significant deterioration relative to baseline at the 12‐month follow‐up with increased DIGEST scores and pharyngeal retention. Shoulder impairment was rare at 1 year in both groups. A comprehensive examination of this cohort treated for OPSCC showed overall good functional and QoL outcomes 1 year after treatment. However, persistent impairment was seen in both groups with regards to swallowing function. In the TORS group, at 12‐months follow‐up, the QoL questionnaires showed worse scores in only one subscale (sticky saliva).

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Section: Introductionmentioning

confidence: 99%

Long‐term quality of life & functional outcomes after treatment of oropharyngeal cancer

et al. 2020

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“…The frequency of SCCUP has significantly increased in recent decades, as illustrated by a single-institution study from the United States in which the mean number of SCCUP cases increased from 3.5 per year in 2005–2008 to 15.6 per year in 2012–2014, in parallel with optimized diagnostic primary tumor-detection rates after implantation of TORS [ 5 ]. A large Danish cohort study also observed a significant rise in palatine tonsil and base of tongue cancers from 2000 to 2017, and the surge in base of tongue cancers is speculated to be originating from increased use of TORS tongue-base mucosectomy in patients with SCCUP [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…The demographic and clinical traits of OPSCC and SCCUP are quite similar. The majority of HPV-positive (+) patients are often males, younger than HPV-negative (-) patients, and tend to exhibit less alcohol and tobacco abuse [ 5 , 6 , 30 ], which are common causes of HPV disease [ 31 , 32 ]. Both groups often exhibit a cystic lymph node metastasis and an early T-stage, which are also the instances when the primary tumor site is identified in SCCUP [ 6 , 33 , 34 , 35 , 36 ].…”

Section: Development Of Hpv Sccupmentioning

confidence: 99%

“…The majority of HPV-positive (+) patients are often males, younger than HPV-negative (-) patients, and tend to exhibit less alcohol and tobacco abuse [ 5 , 6 , 30 ], which are common causes of HPV disease [ 31 , 32 ]. Both groups often exhibit a cystic lymph node metastasis and an early T-stage, which are also the instances when the primary tumor site is identified in SCCUP [ 6 , 33 , 34 , 35 , 36 ]. However, what constitutes the biological differences between SCCUP and OPSCC and causes a small, undetectable primary tumor or regressed tumor to metastasize early to the regional lymph nodes is unknown and still debatable.…”

Section: Development Of Hpv Sccupmentioning

confidence: 99%

“…Patients with SCCUP are estimated to represent up to 10% of the OPSCC cases annually [ 2 ]. In parallel with the sharp increase in the incidence of OPSCC, there has been an escalation of patients with SCCUP which is reported to be linked to the significant increase in human papillomavirus (HPV)-induced OPSCC [ 3 , 4 , 5 , 6 ]. The diagnostic workup of SCCUP is laborious and often includes a clinical examination and radiologic imaging, i.e., whole body positron emission tomography–computed tomography (PET-CT) or magnetic resonance imaging (MRI) [ 7 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Human Papillomavirus and Squamous Cell Carcinoma of Unknown Primary in the Head and Neck Region: A Comprehensive Review on Clinical Implications

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Squamous cell carcinoma of unknown primary (SCCUP) is a challenging diagnostic subgroup of oropharyngeal squamous cell carcinoma (OPSCC). The incidence of SCCUP is increasing in parallel with the well-documented increase in OPSCC and is likewise driven by the increase in human papillomavirus (HPV). The SCCUP patient often presents with a cystic lymph node metastasis and undergoes an aggressive diagnostic and treatment program. Detection of HPV in cytologic specimens indicates an oropharyngeal primary tumor origin and can guide the further diagnostic strategy. Advances in diagnostic modalities, e.g., transoral robotic surgery and transoral laser microsurgery, have increased the successful identification of the primary tumor site in HPV-induced SCCUP, and this harbors a potential for de-escalation treatment and increased survival. This review provides an overview of HPV-induced SCCUP, diagnostic modalities, and treatment options.

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An HPV-Vaccinated Patient With Human Papillomavirus–Positive Oropharyngeal Squamous Cell Carcinoma

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The current epidemic of HPV-associated oropharyngeal cancer: An 18-year Danish population-based study with 2,169 patients

Cited by 82 publications

References 20 publications

Long‐term quality of life & functional outcomes after treatment of oropharyngeal cancer

Long‐term quality of life & functional outcomes after treatment of oropharyngeal cancer

Human Papillomavirus and Squamous Cell Carcinoma of Unknown Primary in the Head and Neck Region: A Comprehensive Review on Clinical Implications

An HPV-Vaccinated Patient With Human Papillomavirus–Positive Oropharyngeal Squamous Cell Carcinoma

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