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Head and Neck
Diagnosis
Primary Sites, Perineural Tumor and Nodes
Naso- and Oropharyngeal Carcinoma
Oropharynx [p16(-)] Carcinoma
Oropharynx [p16(-)] Carcinoma
Philip R. Chapman, MD
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8

OVERVIEW

  • General Comments

    • Classification

      PATHOLOGY

      • General Features

        • Gross Pathology & Surgical Features

          • Routes of Spread

            • Microscopic Features

              IMAGING FINDINGS

              • Detection

                • Staging

                  CLINICAL ISSUES

                  • Presentation

                    • Cancer Natural History & Prognosis

                      • Treatment Options

                        REPORTING CHECKLIST

                        • T Staging

                          • N Staging

                            • M Staging

                              Selected References

                              1. Buckley L et al: HPV-related oropharyngeal carcinoma: a review of clinical and pathologic features with emphasis on updates in clinical and pathologic staging. Adv Anat Pathol. 25(3):180-88, 2018
                              2. Carpén T et al: Presenting symptoms and clinical findings in HPV-positive and HPV-negative oropharyngeal cancer patients. Acta Otolaryngol. 138(5):513-18, 2018
                              3. Rash D et al: Treatment outcomes in HPV-negative oropharyngeal cancer: surgery plus radiotherapy vs. definitive chemoradiotherapy. Ear Nose Throat J. 97(8):E1-E7, 2018
                              4. Szyszko TA et al: PET/CT and PET/MRI in head and neck malignancy. Clin Radiol. 73(1):60-9, 2018
                              5. Amin M.B. et al: AJCC Cancer Staging Manual. 8th Ed. Springer New York, 2017
                              6. Duprez F et al: Distant metastases in head and neck cancer. Head Neck. 39(9):1733-43, 2017
                              7. Goel R et al: Clinical practice in PET/CT for the management of head and neck squamous cell cancer. AJR Am J Roentgenol. 209(2):289-303, 2017
                              8. Kelly JR et al: Comparison of survival outcomes among human papillomavirus-negative ct1-2 n1-2b patients with oropharyngeal squamous cell cancer treated with upfront surgery vs definitive chemoradiation therapy: an observational study. JAMA Oncol. 3(8):1107-1111, 2017
                              9. 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
                              10. Wassef HR et al: PET/CT in head-neck malignancies: the implications for personalized clinical practice. PET Clin. 11(3):219-32, 2016
                              11. Dillon MT et al: Human papillomavirus-negative pharyngeal cancer. J Clin Oncol. 33(29):3251-61, 2015
                              12. Elrefaey S et al: HPV in oropharyngeal cancer: the basics to know in clinical practice. Acta Otorhinolaryngol Ital. 34(5):299-309, 2014
                              13. Kann BH et al: Radiographic extracapsular extension and treatment outcomes in locally advanced oropharyngeal carcinoma. Head Neck. 36(12):1689-94, 2014
                              14. 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
                              15. 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
                              16. Chernock RD: Morphologic features of conventional squamous cell carcinoma of the oropharynx: 'keratinizing' and 'nonkeratinizing' histologic types as the basis for a consistent classification system. Head Neck Pathol. 6 Suppl 1:S41-7, 2012
                              17. Wang Y et al: Pathways for cervical metastasis in malignant neoplasms of the head and neck region. Clin Anat. 25(1):54-71, 2012
                              18. Wu Y et al: Novel biomarker panel predicts prognosis in human papillomavirus-negative oropharyngeal cancer: an analysis of the TAX 324 trial. Cancer. 118(7):1811-7, 2012
                              19. Guido A et al: Combined 18F-FDG-PET/CT imaging in radiotherapy target delineation for head-and-neck cancer. Int J Radiat Oncol Biol Phys. 73(3):759-63, 2009
                              20. Ahuja AT et al: Ultrasound of malignant cervical lymph nodes. Cancer Imaging. 8:48-56, 2008
                              21. King AD et al: The impact of 18F-FDG PET/CT on assessment of nasopharyngeal carcinoma at diagnosis. Br J Radiol. 81(964):291-8, 2008
                              22. Yen RF et al: Early restaging whole-body (18)F-FDG PET during induction chemotherapy predicts clinical outcome in patients with locoregionally advanced nasopharyngeal carcinoma. Eur J Nucl Med Mol Imaging. 32(10):1152-9, 2005
                              23. Vartanian JG et al: Distribution of metastatic lymph nodes in oropharyngeal carcinoma and its implications for the elective treatment of the neck. Arch Otolaryngol Head Neck Surg. 129(7):729-32, 2003
                              24. Werner JA et al: Functional anatomy of the lymphatic drainage system of the upper aerodigestive tract and its role in metastasis of squamous cell carcinoma. Head Neck. 25(4):322-32, 2003
                              Related Anatomy
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                              Related Differential Diagnoses
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                              References
                              Tables

                              Tables

                              OVERVIEW

                              • General Comments

                                • Classification

                                  PATHOLOGY

                                  • General Features

                                    • Gross Pathology & Surgical Features

                                      • Routes of Spread

                                        • Microscopic Features

                                          IMAGING FINDINGS

                                          • Detection

                                            • Staging

                                              CLINICAL ISSUES

                                              • Presentation

                                                • Cancer Natural History & Prognosis

                                                  • Treatment Options

                                                    REPORTING CHECKLIST

                                                    • T Staging

                                                      • N Staging

                                                        • M Staging

                                                          Selected References

                                                          1. Buckley L et al: HPV-related oropharyngeal carcinoma: a review of clinical and pathologic features with emphasis on updates in clinical and pathologic staging. Adv Anat Pathol. 25(3):180-88, 2018
                                                          2. Carpén T et al: Presenting symptoms and clinical findings in HPV-positive and HPV-negative oropharyngeal cancer patients. Acta Otolaryngol. 138(5):513-18, 2018
                                                          3. Rash D et al: Treatment outcomes in HPV-negative oropharyngeal cancer: surgery plus radiotherapy vs. definitive chemoradiotherapy. Ear Nose Throat J. 97(8):E1-E7, 2018
                                                          4. Szyszko TA et al: PET/CT and PET/MRI in head and neck malignancy. Clin Radiol. 73(1):60-9, 2018
                                                          5. Amin M.B. et al: AJCC Cancer Staging Manual. 8th Ed. Springer New York, 2017
                                                          6. Duprez F et al: Distant metastases in head and neck cancer. Head Neck. 39(9):1733-43, 2017
                                                          7. Goel R et al: Clinical practice in PET/CT for the management of head and neck squamous cell cancer. AJR Am J Roentgenol. 209(2):289-303, 2017
                                                          8. Kelly JR et al: Comparison of survival outcomes among human papillomavirus-negative ct1-2 n1-2b patients with oropharyngeal squamous cell cancer treated with upfront surgery vs definitive chemoradiation therapy: an observational study. JAMA Oncol. 3(8):1107-1111, 2017
                                                          9. 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
                                                          10. Wassef HR et al: PET/CT in head-neck malignancies: the implications for personalized clinical practice. PET Clin. 11(3):219-32, 2016
                                                          11. Dillon MT et al: Human papillomavirus-negative pharyngeal cancer. J Clin Oncol. 33(29):3251-61, 2015
                                                          12. Elrefaey S et al: HPV in oropharyngeal cancer: the basics to know in clinical practice. Acta Otorhinolaryngol Ital. 34(5):299-309, 2014
                                                          13. Kann BH et al: Radiographic extracapsular extension and treatment outcomes in locally advanced oropharyngeal carcinoma. Head Neck. 36(12):1689-94, 2014
                                                          14. 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
                                                          15. 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
                                                          16. Chernock RD: Morphologic features of conventional squamous cell carcinoma of the oropharynx: 'keratinizing' and 'nonkeratinizing' histologic types as the basis for a consistent classification system. Head Neck Pathol. 6 Suppl 1:S41-7, 2012
                                                          17. Wang Y et al: Pathways for cervical metastasis in malignant neoplasms of the head and neck region. Clin Anat. 25(1):54-71, 2012
                                                          18. Wu Y et al: Novel biomarker panel predicts prognosis in human papillomavirus-negative oropharyngeal cancer: an analysis of the TAX 324 trial. Cancer. 118(7):1811-7, 2012
                                                          19. Guido A et al: Combined 18F-FDG-PET/CT imaging in radiotherapy target delineation for head-and-neck cancer. Int J Radiat Oncol Biol Phys. 73(3):759-63, 2009
                                                          20. Ahuja AT et al: Ultrasound of malignant cervical lymph nodes. Cancer Imaging. 8:48-56, 2008
                                                          21. King AD et al: The impact of 18F-FDG PET/CT on assessment of nasopharyngeal carcinoma at diagnosis. Br J Radiol. 81(964):291-8, 2008
                                                          22. Yen RF et al: Early restaging whole-body (18)F-FDG PET during induction chemotherapy predicts clinical outcome in patients with locoregionally advanced nasopharyngeal carcinoma. Eur J Nucl Med Mol Imaging. 32(10):1152-9, 2005
                                                          23. Vartanian JG et al: Distribution of metastatic lymph nodes in oropharyngeal carcinoma and its implications for the elective treatment of the neck. Arch Otolaryngol Head Neck Surg. 129(7):729-32, 2003
                                                          24. Werner JA et al: Functional anatomy of the lymphatic drainage system of the upper aerodigestive tract and its role in metastasis of squamous cell carcinoma. Head Neck. 25(4):322-32, 2003
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