Over the past decade, advanced oropharyngeal squamous cell carcinoma has been treated with adjuvant chemoradiotherapy. Advances in surgical technique, along with the recognition of unique characteristics with a more benign clinical course associated with human papillomavirus–positive disease, has led to a resurgence in the use of surgery with adjuvant therapy. Spector and colleagues evaluated the prevalence of various pathological features, including pathologic retropharyngeal adenopathy, to develop an algorithm for deintensification of therapy, which excludes the retropharyngeal site from the treatment volume in an attempt to decrease toxic effects. No clear algorithm could be created to exclude the retropharyngeal site. Gourin provides an Invited Commentary.
Highlights. JAMA Otolaryngol Head Neck Surg. 2016;142(4):307. doi:10.1001/jamaoto.2015.1797
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