The role of surgery for HPV-associated head and neck cancer

Oral Oncol. 2015 Apr;51(4):305-13. doi: 10.1016/j.oraloncology.2014.10.005. Epub 2014 Oct 30.


The incidence of human papillomavirus (HPV)-associated oropharyngeal cancer continues to increase in contrast to other head and neck cancer sites. There is a growing role for upfront surgery to treat these cancers in the era of organ preservation treatment strategies. This is becoming especially important in younger, healthier patients with HPV-associated squamous cell carcinoma. Surgery for oropharyngeal cancer has evolved from large, open transcervical and transmandibular approaches to minimally-invasive transoral endoscopic techniques. Advances in transoral endoscopic surgery (TES) have led to renewed interest in upfront surgical treatment for oropharyngeal carcinoma. Transoral laser microsurgery (TLM) and transoral robotic surgery (TORS) are two techniques that allow for complete oncologic resection through the mouth in select patients, with minimal cosmetic deformity and optimal speech and swallow function after completion of therapy. In this article we will review transoral approaches to oropharyngeal carcinoma: its oncologic and functional outcomes, and its role in the multi-disciplinary treatment of oropharyngeal cancer.

Keywords: HPV; Head and neck cancer; Human papillomavirus; Minimally-invasive; Transoral laser microsurgery; Transoral robotic surgery.

Publication types

  • Review

MeSH terms

  • Alphapapillomavirus / isolation & purification*
  • Carcinoma, Squamous Cell / surgery*
  • Carcinoma, Squamous Cell / virology
  • Head and Neck Neoplasms / surgery*
  • Head and Neck Neoplasms / virology
  • Humans
  • Tumor Virus Infections / surgery*
  • Tumor Virus Infections / virology