Overall better prognosis than conventional SCCa; patients with OPSCCa-HPV may be candidates for less aggressive therapy compared to HPV-negative OPSCCa
New TNM classification exclusively for HPV-related OPSCCa added in latest 8th edition (2017) of AJCC Cancer Staging Manual
IMAGING
General Features
CT Findings
MR Findings
Ultrasonographic Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
Human Papillomavirus
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Chidambaram S et al: Prognostic significance of smoking in human papillomavirus-positive oropharyngeal cancer under American Joint Committee on Cancer Eighth Edition Stage. Laryngoscope. 130(8):1961-6, 2020
Hoffmann M et al: HPV and oropharyngeal cancer in the Eighth Edition of the TNM Classification: pitfalls in practice. Transl Oncol. 12(8):1108-12, 2019
Parvathaneni U et al: Advances in diagnosis and multidisciplinary management of oropharyngeal squamous cell carcinoma: state of the art. Radiographics. 39(7):2055-68, 2019
Ravanelli M et al: Correlation between human papillomavirus status and quantitative MR imaging parameters including diffusion-weighted imaging and texture features in oropharyngeal carcinoma. AJNR Am J Neuroradiol. 39(10):1878-83, 2018
Lydiatt WM et al: Head and neck cancers-major changes in the American Joint Committee on Cancer Eighth Edition Cancer Staging Manual. CA Cancer J Clin. 67(2):122-37, 2017
Anantharaman D et al: Combined effects of smoking and HPV16 in oropharyngeal cancer. Int J Epidemiol. ePub, 2016
Gooi Z et al: The epidemiology of the human papillomavirus related to oropharyngeal head and neck cancer. Laryngoscope. 126(4):894-900, 2016
Horne ZD et al: Confirmation of proposed human papillomavirus risk-adapted staging according to AJCC/UICC TNM criteria for positive oropharyngeal carcinomas. Cancer. 122(13):2021-30, 2016
Sano D et al: The molecular mechanism of human papillomavirus-induced carcinogenesis in head and neck squamous cell carcinoma. Int J Clin Oncol. ePub, 2016
Truong Lam M et al: Challenges in establishing the diagnosis of human papillomavirus-related oropharyngeal carcinoma. Laryngoscope. ePub, 2016
Vainshtein JM et al: Matted nodes: High distant-metastasis risk and a potential indication for intensification of systemic therapy in human papillomavirus-related oropharyngeal cancer. Head Neck. 38 Suppl 1:E805-14, 2016
Baxter M et al: Retropharyngeal lymph node involvement in human papillomavirus-associated oropharyngeal squamous cell carcinoma. Laryngoscope. 125(11):2503-8, 2015
Hinni ML et al: Oropharyngeal cancer treatment: the role of transoral surgery. Curr Opin Otolaryngol Head Neck Surg. 23(2):132-8, 2015
Kendi AT et al: Do 18F-FDG PET/CT parameters in oropharyngeal and oral cavity squamous cell carcinomas indicate HPV status? Clin Nucl Med. 40(3):e196-200, 2015
Samuels SE et al: Impact of retropharyngeal adenopathy on distant control and survival in HPV-related oropharyngeal cancer treated with chemoradiotherapy. Radiother Oncol. 116(1):75-81, 2015
Deschler DG et al: The "new" head and neck cancer patient-young, nonsmoker, nondrinker, and HPV positive: evaluation. Otolaryngol Head Neck Surg. 151(3):375-80, 2014
Koshkareva Y et al: Predictive accuracy of first post-treatment PET/CT in HPV-related oropharyngeal squamous cell carcinoma. Laryngoscope. 124(8):1843-7, 2014
Subramaniam RM et al: PET/CT imaging and human papilloma virus-positive oropharyngeal squamous cell cancer: evolving clinical imaging paradigm. J Nucl Med. 55(3):431-8, 2014
Tahari AK et al: FDG PET/CT imaging of oropharyngeal squamous cell carcinoma: characteristics of human papillomavirus-positive and -negative tumors. Clin Nucl Med. 39(3):225-31, 2014
Trinkaus ME et al: Correlation of p16 status, hypoxic imaging using [18F]-misonidazole positron emission tomography and outcome in patients with loco-regionally advanced head and neck cancer. J Med Imaging Radiat Oncol. 58(1):89-97, 2014
Cantrell SC et al: Differences in imaging characteristics of HPV-positive and HPV-Negative oropharyngeal cancers: a blinded matched-pair analysis. AJNR Am J Neuroradiol. 34(10):2005-9, 2013
Genden EM et al: Human papillomavirus and oropharyngeal squamous cell carcinoma: what the clinician should know. Eur Arch Otorhinolaryngol. Epub ahead of print, 2012
Loevner LA et al: Transoral robotic surgery in head and neck cancer: what radiologists need to know about the cutting edge. Radiographics. 33(6):1759-79, 2013
Corey AS et al: Radiographic imaging of human papillomavirus related carcinomas of the oropharynx. Head Neck Pathol. 6 Suppl 1:S25-40, 2012
Haerle SK et al: Contrast-enhanced ¹⁸F-FDG-PET/CT for the assessment of necrotic lymph node metastases. Head Neck. 33(3):324-9, 2011
Zhang I et al: The benefit of early PET/CT surveillance in HPV-associated head and neck squamous cell carcinoma. Arch Otolaryngol Head Neck Surg. 137(11):1106-11, 2011
Ang KK et al: Human papillomavirus and survival of patients with oropharyngeal cancer. N Engl J Med. 363(1):24-35, 2010
Attner P et al: The role of human papillomavirus in the increased incidence of base of tongue cancer. Int J Cancer. 126(12):2879-84, 2010
Chaturvedi AK: Beyond cervical cancer: burden of other HPV-related cancers among men and women. J Adolesc Health. 46(4 Suppl):S20-6, 2010
Glombitza F et al: HPV status in head and neck tumors. Pathol Res Pract. 206(4):229-34, 2010
Heck JE et al: Sexual behaviours and the risk of head and neck cancers: a pooled analysis in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. Int J Epidemiol. 39(1):166-81, 2010
Maxwell JH et al: Tobacco use in human papillomavirus-positive advanced oropharynx cancer patients related to increased risk of distant metastases and tumor recurrence. Clin Cancer Res. 16(4):1226-35, 2010
Singhi AD et al: Lymphoepithelial-like carcinoma of the oropharynx: a morphologic variant of HPV-related head and neck carcinoma. Am J Surg Pathol. 34(6):800-5, 2010
StatBite: Proportion of specific cancers caused by HPV. J Natl Cancer Inst. 102(12):839, 2010
Chung CH et al: Human papillomavirus in head and neck cancer: its role in pathogenesis and clinical implications. Clin Cancer Res. 15(22):6758-62, 2009
Gillespie MB et al: Human papillomavirus and oropharyngeal cancer: what you need to know in 2009. Curr Treat Options Oncol. 10(5-6):296-307, 2009
Gillison ML: HPV and prognosis for patients with oropharynx cancer. Eur J Cancer. 45 Suppl 1:383-5, 2009
Gillison ML: Oropharyngeal cancer: a potential consequence of concomitant HPV and HIV infection. Curr Opin Oncol. 21(5):439-44, 2009
Hudgins PA, Gillison M. Second branchial cleft cyst: not!! AJNR Am J Neuroradiol. 30(9):1628-9, 2009
Luginbuhl A et al: Prevalence, morphology, and prognosis of human papillomavirus in tonsillar cancer. Ann Otol Rhinol Laryngol. 118(10):742-9, 2009
Printz C: CancerScope: HPV vaccine for boys and men? It could help reduce incidence of cervical and head and neck cancers. Cancer. 115(22):5129-30, 2009
Printz C: CancerScope: Patients with HPV-linked throat cancer fare better than others. Cancer. 115(22):5131, 2009
Settle K et al: Racial survival disparity in head and neck cancer results from low prevalence of human papillomavirus infection in black oropharyngeal cancer patients. Cancer Prev Res (Phila Pa). 2(9):776-81, 2009
Straetmans JM et al: Human papillomavirus reduces the prognostic value of nodal involvement in tonsillar squamous cell carcinomas. Laryngoscope. 119(10):1951-7, 2009
Goldenberg D et al: Cystic lymph node metastasis in patients with head and neck cancer: An HPV-associated phenomenon. Head Neck. 30(7):898-903, 2008
D'Souza G et al: Case-control study of human papillomavirus and oropharyngeal cancer. N Engl J Med. 356(19):1944-56, 2007
Current College of American Pathologists (CAP) Guidelines: Human Papillomavirus Testing in Head and Neck Carcinomas. https://www.cap.org/protocols-and-guidelines/cap-guidelines/current-cap-guidelines/human-papillomavirus-testing-in-head-and-neck-carcinomas
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
Human papillomavirus (HPV)
Oropharyngeal squamous cell carcinoma (OPSCCa)
American Joint Committee on Cancer (AJCC)
Synonyms
HPV-mediated [p16(+)] oropharyngeal carcinoma
Definitions
Subcategory of OPSCCa caused by HPV infection
Overall better prognosis than conventional SCCa; patients with OPSCCa-HPV may be candidates for less aggressive therapy compared to HPV-negative OPSCCa
New TNM classification exclusively for HPV-related OPSCCa added in latest 8th edition (2017) of AJCC Cancer Staging Manual
IMAGING
General Features
CT Findings
MR Findings
Ultrasonographic Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
Human Papillomavirus
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Chidambaram S et al: Prognostic significance of smoking in human papillomavirus-positive oropharyngeal cancer under American Joint Committee on Cancer Eighth Edition Stage. Laryngoscope. 130(8):1961-6, 2020
Hoffmann M et al: HPV and oropharyngeal cancer in the Eighth Edition of the TNM Classification: pitfalls in practice. Transl Oncol. 12(8):1108-12, 2019
Parvathaneni U et al: Advances in diagnosis and multidisciplinary management of oropharyngeal squamous cell carcinoma: state of the art. Radiographics. 39(7):2055-68, 2019
Ravanelli M et al: Correlation between human papillomavirus status and quantitative MR imaging parameters including diffusion-weighted imaging and texture features in oropharyngeal carcinoma. AJNR Am J Neuroradiol. 39(10):1878-83, 2018
Lydiatt WM et al: Head and neck cancers-major changes in the American Joint Committee on Cancer Eighth Edition Cancer Staging Manual. CA Cancer J Clin. 67(2):122-37, 2017
Anantharaman D et al: Combined effects of smoking and HPV16 in oropharyngeal cancer. Int J Epidemiol. ePub, 2016
Gooi Z et al: The epidemiology of the human papillomavirus related to oropharyngeal head and neck cancer. Laryngoscope. 126(4):894-900, 2016
Horne ZD et al: Confirmation of proposed human papillomavirus risk-adapted staging according to AJCC/UICC TNM criteria for positive oropharyngeal carcinomas. Cancer. 122(13):2021-30, 2016
Sano D et al: The molecular mechanism of human papillomavirus-induced carcinogenesis in head and neck squamous cell carcinoma. Int J Clin Oncol. ePub, 2016
Truong Lam M et al: Challenges in establishing the diagnosis of human papillomavirus-related oropharyngeal carcinoma. Laryngoscope. ePub, 2016
Vainshtein JM et al: Matted nodes: High distant-metastasis risk and a potential indication for intensification of systemic therapy in human papillomavirus-related oropharyngeal cancer. Head Neck. 38 Suppl 1:E805-14, 2016
Baxter M et al: Retropharyngeal lymph node involvement in human papillomavirus-associated oropharyngeal squamous cell carcinoma. Laryngoscope. 125(11):2503-8, 2015
Hinni ML et al: Oropharyngeal cancer treatment: the role of transoral surgery. Curr Opin Otolaryngol Head Neck Surg. 23(2):132-8, 2015
Kendi AT et al: Do 18F-FDG PET/CT parameters in oropharyngeal and oral cavity squamous cell carcinomas indicate HPV status? Clin Nucl Med. 40(3):e196-200, 2015
Samuels SE et al: Impact of retropharyngeal adenopathy on distant control and survival in HPV-related oropharyngeal cancer treated with chemoradiotherapy. Radiother Oncol. 116(1):75-81, 2015
Deschler DG et al: The "new" head and neck cancer patient-young, nonsmoker, nondrinker, and HPV positive: evaluation. Otolaryngol Head Neck Surg. 151(3):375-80, 2014
Koshkareva Y et al: Predictive accuracy of first post-treatment PET/CT in HPV-related oropharyngeal squamous cell carcinoma. Laryngoscope. 124(8):1843-7, 2014
Subramaniam RM et al: PET/CT imaging and human papilloma virus-positive oropharyngeal squamous cell cancer: evolving clinical imaging paradigm. J Nucl Med. 55(3):431-8, 2014
Tahari AK et al: FDG PET/CT imaging of oropharyngeal squamous cell carcinoma: characteristics of human papillomavirus-positive and -negative tumors. Clin Nucl Med. 39(3):225-31, 2014
Trinkaus ME et al: Correlation of p16 status, hypoxic imaging using [18F]-misonidazole positron emission tomography and outcome in patients with loco-regionally advanced head and neck cancer. J Med Imaging Radiat Oncol. 58(1):89-97, 2014
Cantrell SC et al: Differences in imaging characteristics of HPV-positive and HPV-Negative oropharyngeal cancers: a blinded matched-pair analysis. AJNR Am J Neuroradiol. 34(10):2005-9, 2013
Genden EM et al: Human papillomavirus and oropharyngeal squamous cell carcinoma: what the clinician should know. Eur Arch Otorhinolaryngol. Epub ahead of print, 2012
Loevner LA et al: Transoral robotic surgery in head and neck cancer: what radiologists need to know about the cutting edge. Radiographics. 33(6):1759-79, 2013
Corey AS et al: Radiographic imaging of human papillomavirus related carcinomas of the oropharynx. Head Neck Pathol. 6 Suppl 1:S25-40, 2012
Haerle SK et al: Contrast-enhanced ¹⁸F-FDG-PET/CT for the assessment of necrotic lymph node metastases. Head Neck. 33(3):324-9, 2011
Zhang I et al: The benefit of early PET/CT surveillance in HPV-associated head and neck squamous cell carcinoma. Arch Otolaryngol Head Neck Surg. 137(11):1106-11, 2011
Ang KK et al: Human papillomavirus and survival of patients with oropharyngeal cancer. N Engl J Med. 363(1):24-35, 2010
Attner P et al: The role of human papillomavirus in the increased incidence of base of tongue cancer. Int J Cancer. 126(12):2879-84, 2010
Chaturvedi AK: Beyond cervical cancer: burden of other HPV-related cancers among men and women. J Adolesc Health. 46(4 Suppl):S20-6, 2010
Glombitza F et al: HPV status in head and neck tumors. Pathol Res Pract. 206(4):229-34, 2010
Heck JE et al: Sexual behaviours and the risk of head and neck cancers: a pooled analysis in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. Int J Epidemiol. 39(1):166-81, 2010
Maxwell JH et al: Tobacco use in human papillomavirus-positive advanced oropharynx cancer patients related to increased risk of distant metastases and tumor recurrence. Clin Cancer Res. 16(4):1226-35, 2010
Singhi AD et al: Lymphoepithelial-like carcinoma of the oropharynx: a morphologic variant of HPV-related head and neck carcinoma. Am J Surg Pathol. 34(6):800-5, 2010
StatBite: Proportion of specific cancers caused by HPV. J Natl Cancer Inst. 102(12):839, 2010
Chung CH et al: Human papillomavirus in head and neck cancer: its role in pathogenesis and clinical implications. Clin Cancer Res. 15(22):6758-62, 2009
Gillespie MB et al: Human papillomavirus and oropharyngeal cancer: what you need to know in 2009. Curr Treat Options Oncol. 10(5-6):296-307, 2009
Gillison ML: HPV and prognosis for patients with oropharynx cancer. Eur J Cancer. 45 Suppl 1:383-5, 2009
Gillison ML: Oropharyngeal cancer: a potential consequence of concomitant HPV and HIV infection. Curr Opin Oncol. 21(5):439-44, 2009
Hudgins PA, Gillison M. Second branchial cleft cyst: not!! AJNR Am J Neuroradiol. 30(9):1628-9, 2009
Luginbuhl A et al: Prevalence, morphology, and prognosis of human papillomavirus in tonsillar cancer. Ann Otol Rhinol Laryngol. 118(10):742-9, 2009
Printz C: CancerScope: HPV vaccine for boys and men? It could help reduce incidence of cervical and head and neck cancers. Cancer. 115(22):5129-30, 2009
Printz C: CancerScope: Patients with HPV-linked throat cancer fare better than others. Cancer. 115(22):5131, 2009
Settle K et al: Racial survival disparity in head and neck cancer results from low prevalence of human papillomavirus infection in black oropharyngeal cancer patients. Cancer Prev Res (Phila Pa). 2(9):776-81, 2009
Straetmans JM et al: Human papillomavirus reduces the prognostic value of nodal involvement in tonsillar squamous cell carcinomas. Laryngoscope. 119(10):1951-7, 2009
Goldenberg D et al: Cystic lymph node metastasis in patients with head and neck cancer: An HPV-associated phenomenon. Head Neck. 30(7):898-903, 2008
D'Souza G et al: Case-control study of human papillomavirus and oropharyngeal cancer. N Engl J Med. 356(19):1944-56, 2007
Current College of American Pathologists (CAP) Guidelines: Human Papillomavirus Testing in Head and Neck Carcinomas. https://www.cap.org/protocols-and-guidelines/cap-guidelines/current-cap-guidelines/human-papillomavirus-testing-in-head-and-neck-carcinomas
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