Predominantly (90%) squamous cell carcinoma arising from base of tongue, soft palate, palatine tonsillar fossa and pillars, and lateral and posterior pharyngeal wall. Nonepithelial tumors such as minor salivary gland carcinomas and sarcoma are uncommon.
Tobacco and alcohol abuse are the strongest predictors of developing oropharyngeal carcinoma. HPV infection is strongly implicated in people not exposed to smoking or alcohol. Betel nut chewing in developing countries is also a risk factor.
Signs include sore throat, oral pain, dysphagia, weight loss, neck mass, and trismus.
Patients should be referred to an ear, nose, and throat surgeon for histology diagnosis of cancer.
Staging is through CT scan or MRI of the head and neck with contrast, followed by triple endoscopy under general anesthesia. However, PET scan either alone or combined with CT scan has become an acceptable method.
Treatment regimens vary depending on the stage of the cancer and involve surgery, chemotherapy, radiation, and monoclonal antibodies. Patients should be managed by a multidisciplinary team to optimize outcome.
Oropharyngeal cancer is predominantly (90%) a squamous cell carcinoma arising from the subsites of the oropharynx: the base of tongue, soft palate, palatine tonsillar fossa and pillars, and lateral and posterior pharyngeal wall.  Nonepithelial tumors such as minor salivary gland carcinomas and sarcoma are uncommon.
Professor and Chair
Radiation Oncology Department
NPN is an author of a number of references cited in this monograph.
Assistant Professor of Radiology
University of Arizona
FA declares that he has no competing interests.
Dr Nam P. Nguyen and Dr Fabio Almeida would like to gratefully acknowledge Dr Linda Garland, a previous contributor to this monograph. LG is on the speakers' bureau for Sanofi-Aventis, maker of Taxotere.
Multidisciplinary Head & Neck Team
Department of Head & Neck Oncology and Surgery
The Netherlands Cancer Institute
AJB declares that he has no competing interests.
Specializing in Head & Neck Cancer
Director of Clinical Trials
H. Lee Moffitt Cancer Center & Research Institute
AT is an author of a reference cited in this monograph.
Assistant Professor of Medicine
Yale Cancer Center
HD is on the speakers' bureau for Sanofi-Aventis and has received reimbursement for talks given about their product Taxotere.
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