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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?
Gourin CG. The Significance of Retropharyngeal Nodes in Treatment Deintensification. JAMA Otolaryngol Head Neck Surg. 2016;142(4):319-320. doi:10.1001/jamaoto.2016.0122