hpv associated oropharyngeal cancer
DESCRIPTION
HPV Associated Oropharyngeal Cancer. Benjamin L. Judson, M.D. 10/ 19/ 2013. No conflict of interest. Benjamin L. Judson, M.D. 10/ 19/ 2013. HPV in the Head & Neck. Types 6 and 11 R ecurrent respiratory papillomatosis Types 16 and 18 Previously no role in head & neck. - PowerPoint PPT PresentationTRANSCRIPT
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Author : Updated :
HPV Associated Oropharyngeal Cancer
Benjamin L. Judson, M.D.10/19/2013
333 Cedar StreetNew Haven, Connecticut 06510
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Author : Updated :
No conflict of interest.
Benjamin L. Judson, M.D.10/19/2013
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3.3.
• Types 6 and 11– Recurrent respiratory papillomatosis
• Types 16 and 18 – Previously no role in head & neck
HPV in the Head & Neck
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4.4. Head & Neck Cancer
melanoma thyroid oral cavity, pharynx,
larynx
lymphoma colon lung0
50000
100000
150000
200000
250000deaths new cases
Cancer Facts and Figures 2011, American Cancer Society
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5.
Oropharynx-tonsils-base of tongue
Larynx
Nasopharynx
Hypopharynx
Oral Cavity
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6.6. Smoking Prevalence: 1965 - 2005
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7.7. Different Incidence
Chaturvedi AK, et al. J Clin Oncol 2008; 26: 612–19.
Oropharynx
Oral Cavity, Larynx, Nasopharynx, Hypopharynx
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8.8.
Chaturvedi A K et al. JCO 2011;29:4294-4301
Increase in HPV Associated Oropharyngeal Cancer
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9.9.
Pytynia KB et al. Oral Oncol. 2014 Jan 21.
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10.
Oropharynx-tonsils-base of tongue
Larynx
Nasopharynx
Hypopharynx
Oral Cavity
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11.11. Changing Face of Head and Neck Cancer
Sturgis EM, Cinciripini PM. Trends in head and neck cancer incidence in relation to smoking prevalence: an emerging epidemic of human papillomavirus-associated cancers? Cancer. 2007 Oct 1;110(7):1429-35. Review.
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12.12.
• Risk increases with number of lifetime – vaginal-sex partners (26 or more) – oral-sex partners (6 or more)
Different Risk Factors
D’Souza et al. Case-control study of human papillomavirus and oropharyngeal cancer. N Engl J Med 2007; 356:1944–1956.Sikora AG et al. Bidirectional association of anogenital and oral cavity/pharyngeal carcinomas in men. Arch Otolaryngol Head Neck Surg. 2009 135(4):402-5.
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13.13.
Smaller primary tumor
Different Presentation
Straetmans JM et al. Laryngoscope. 2009 Oct;119:1951-7.Gillison ML et al. JNCI. 2008;100(4):261-269.
Bulky/cystic nodal metastasis
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14.14.
• Trans oral vizualization is limited:
Different Presentation
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15.15. Different Histology
Basaloid poorly
differentiated
P16 + HPV +
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16.16. Different Survival
Ang KK et al. N Engl J Med 2010;363:24-35
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17.17. Different Risk with Tobacco Exposure
Ang KK et al. N Engl J Med 2010;363:24-35
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18.18.
• HPV is causing an epidemic of oropharynx cancer
• Affects men more than women
• Risk of HPV causing oropharynx cancer surpassing that of cervical cancer
Conclusion
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19.19.
• Thank you!