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Invited Commentary
April 2016

The Significance of Retropharyngeal Nodes in Treatment Deintensification

Author Affiliations
  • 1Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland

Copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Otolaryngol Head Neck Surg. 2016;142(4):319-320. doi:10.1001/jamaoto.2016.0122

Treatment deintensification of human papillomavirus (HPV) associated oropharyngeal squamous cell cancer (OPSCC) is a topic of active debate. It is well recognized that HPV-associated OPSCC has unique tumor biological characteristics, reflected by a high propensity for nodal involvement and yet more favorable outcomes compared with HPV-negative OPSCC, with significantly improved overall survival and a reduced risk of recurrence. Because patients with HPV-associated OPSCC are often younger (<60 years), healthier, and more likely to outlive their disease than their historical counterparts, efforts to reduce the risk of severe late toxicity, primarily long-term dysphagia, have become a goal of treatment. The primary question now is, which of these patients are candidates for treatment deintensification?

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