Preventing major postoperative haemorrhage following TORS

Transoral robotic surgery (TORS) has become an increasingly utilised treatment modality in the management of oropharyngeal squamous cell carcinoma (OPSCC). Postoperative haemorrhage, although uncommon, is a significant complication. To ameliorate this risk, transcervical ligation of branches of the external carotid...

Active smoking predicts poor outcome in HPV positive oropharyngeal squamous cell carcinoma

Tobacco smoking is a well-known risk factor in human papilloma virus (HPV)-negative head and neck squamous cell cancer. Its effects include increased risk of treatment failure, distant metastases and reduced overall survival. HPV has been increasingly implicated as a causative...

Significance of abnormal retropharyngeal nodes in head and neck cancer

Abnormal retropharyngeal lymph nodes (RLN) have prognostic relevance for patients with oral, oropharyngeal or nasopharyngeal squamous cell carcinoma (SCC). However, consensus on the evaluation and management of abnormal RLN in these patients is lacking. The authors of this paper provided...

Impact of the updated cancer staging system on HPV-positive disease

The AJCC cancer staging manual was updated in 2017 (8th edition). It is used in the MDT setting for planning treatment and assessing prognosis for individual patients, and is also widely used internationally in clinical trials. Unlike previous iterations of...

Which da Vinci surgical system? Novel flexible, single-port versus current multiport, rigid-arm robotic surgical system

The da Vinci robotic surgical system has transformed how oropharyngeal head and neck surgery can be delivered. The existing da Vinci Si model has challenges: the dimensions of this are larger than would be ideal for head and neck surgery...

An algorithm to distinguish between distant metastases and metachronous lung primary in patients with HPV-related oropharyngeal cancer

Distinguishing between distant metastases of HPV-related oropharyngeal squamous cell carcinoma (OPSCC) and metachronous primary lung squamous cell carcinoma (SCC) is important as it has implications for treatment, prognosis counselling, and registry data. Although p16 immunohistochemistry (p16 IHC) is widely accepted...

Predicting which oropharyngeal SCC HPV-positive patients should avoid de-escalated treatment

This study is timely for many reasons and raises very important questions in the management of the current rise in HPV-positive patients with oropharyngeal cancer (OPC). The uniqueness of this group within head and neck cancer in terms of favourable...

Trends in the incidence of oropharyngeal cancer

The recent rise in HPV-related oropharyngeal squamous cell carcinoma is well described. There has been a significant shift from tobacco-driven to virus-driven cancers at this anatomical site. This retrospective study analysed US tumour registry data over a long period (1973–2009)...

Contemporary UK experience of oropharyngeal transoral laser microsurgery

It is well recognised that the current emergence of HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) as a distinct disease entity requires a fresh look at standard treatment modalities that are based on chemoradiotherapy for stage III/IVa OPSCC. The Newcastle experience...

Difficult consultations with HPV-positive oropharnyeal cancer patients

The aetiological role of human papillomavirus (HPV) in oropharyngeal squamous cell carcinoma (OPSCC) is well established, and its incidence has massively increased over the last decade, whilst the incidence of HPV-negative OPSCC is declining. Although we know that HPV-positive OPSCC...

Risk factors for TORS treatment failure in HPV-related oropharyngeal cancers

HPV-related squamous cell cancers are an increasingly common cause of malignancy in the oropharynx. There is evidence that these cancers are associated with a significantly improved overall survival compared to conventional HPV-negative tumours. The optimal treatment for such cancers is...

The stigma of HPV in oral cancer

The increase of oropharyngeal carcinoma (OPC) in the developed world seems to be largely caused by infection with the human papillomavirus (HPV). HPV is a group of 150 DNA viruses that are common and most people will be infected at...