Oropharyngeal cancer

Last reviewed: 21 Apr 2022
Last updated: 03 Sep 2020

Summary

Definition

History and exam

Key diagnostic factors

  • oral pain
  • weight loss
More key diagnostic factors

Other diagnostic factors

  • sore throat
  • neck lump
  • indurated or ulcerated mass
  • dysphagia
  • neck lymphadenopathy
  • otalgia
  • trismus
  • white (leukoplakia) and red plaques (erythroplakia)
Other diagnostic factors

Risk factors

  • presence of risk factors
  • smoking cigarettes
  • alcohol
  • human papillomavirus (HPV)-16 infection
  • tobacco and betel nut chewing
More risk factors

Diagnostic investigations

1st investigations to order

  • biopsy of the primary site
  • PET-CT of the head and neck
  • fine needle aspiration cytology (FNAC) of neck nodes
  • excision biopsy of neck nodes
More 1st investigations to order

Investigations to consider

  • CT scan of the head and neck
  • MRI of the head and neck
  • panendoscopy or triple endoscopy
  • modified barium swallow
  • in situ hybridisation for HPV-16, p16 immunohistochemistry, or PCR in biopsy specimen
  • FBC
  • electrolytes
  • blood urea/nitrogen
  • serum creatinine
  • total protein
  • albumin
  • pre-albumin
  • LFTs
More investigations to consider

Treatment algorithm

ACUTE

stage I or II (early stage disease)

stage III or IVA (locally advanced and resectable)

stage IVB (locally advanced and unresectable)

stage IVC (distant metastases at presentation)

ONGOING

recurrent disease

Contributors

Authors

Nam P. Nguyen, MD

Professor and Chair

Radiation Oncology Department

Howard University

Washington

DC

Disclosures

NPN is an author of a number of references cited in this topic.

Fabio Almeida, MD

Assistant Professor of Radiology

University of Arizona

Tucson

AZ

Disclosures

FA declares that he has no competing interests.

Acknowledgements

Dr Nam P. Nguyen and Dr Fabio Almeida would like to gratefully acknowledge Dr Linda Garland, a previous contributor to this topic.

Disclosures

LG is on the speakers' bureau for Sanofi-Aventis, maker of Taxotere.

Peer reviewers

AJ Balm, MD, PhD, FACS, FRCS

Chair Emeritus

Head and Neck Multidisciplinary Cooperative Group

Department of Head & Neck Oncology and Surgery

The Netherlands Cancer Institute

Amsterdam

The Netherlands

Disclosures

AJB declares that he has no competing interests.

Andy Trotti, MD

Specializing in Head & Neck Cancer

Director of Clinical Trials

Radiation Oncology

H. Lee Moffitt Cancer Center & Research Institute

Tampa

FL

Disclosures

AT is an author of a reference cited in this topic.

Hari Deshpande, MD

Assistant Professor of Medicine

Yale Cancer Center

Yale University

New Haven

CT

Disclosures

HD is on the speakers' bureau for Sanofi-Aventis and has received reimbursement for talks given about their product Taxotere.

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