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Updated: Dec 25, 2025
Chromogenic In Situ Hybridization as a Tool for HPV-Related Head and Neck Cancer Diagnosis
Published on: June 14, 2019
Neoadjuvant chemotherapy followed by surgery for HPV-associated locoregionally advanced oropharynx cancer
Nader Sadeghi1,2, Marco A Mascarella1,3, Sarah Khalife1
1Department of Otolaryngology - Head and Neck Surgery, McGill University Health Center, McGill University, Montreal, Quebec, Canada.
Background:
Neoadjuvant chemotherapy followed by surgery (NAC + S), a paradigm based on systemic escalation coupled with surgery-based de-escalation, is under investigation for treatment of HPV-associated oropharynx cancer (OPC).
Methods:
Prospective cohort of patients with non-metastatic, p16 positive OPC enrolled in a clinical trial of NAC + S was compared to a historic cohort of patients undergoing concurrent chemoradiation (CCRT) to compare disease-free survival (DFS).
Results:
Fifty-five patients were treated with NAC + S and 142 with CCRT. Stage-matched patients undergoing CCRT had higher frequency of smoking and alcohol consumption. 5-year DFS in the NAC + S group was 96.1% (95% CI 90.8-100) compared to 67.6% (95% CI 50.7-84.5) for CCRT (P = .01). At 12 months from treatment, 24.5% of patients undergoing CCRT and none of the patients in the NAC + S were feeding tube dependent (P < .0001).
Conclusion:
NAC + S may be a novel approach for HPV-associated OPC as it provides lower feeding tube dependence and improved survival compared to stage-matched patients undergoing CCRT.
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