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Immunotherapeutic Approaches to Head and Neck Squamous Cell Carcinoma: Current Clinical Practice and Future Directions.

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Related Experiment Video

Updated: Jan 9, 2026

Chromogenic In Situ Hybridization as a Tool for HPV-Related Head and Neck Cancer Diagnosis
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Minimizing Chemoradiation Using a Surgical Algorithm for HPV-Associated Cancer of Unknown Primary.

Georges E Daoud1, Andre J Burnham2, Nikhil T Vettikattu2

  • 1Department of Otolaryngology-Head and Neck Surgery, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.

Head & Neck
|December 8, 2025
PubMed
Summary

Transoral robotic surgery (TORS) accurately identifies HPV-associated cancer of unknown primary (CUP) in the head and neck. This approach helps reduce the need for radiation therapy, improving patient outcomes.

Keywords:
cancer of unknown primaryhuman papilloma virusoropharyngeal squamous cell carcinomatransoral robotic surgery

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Area of Science:

  • Otolaryngology
  • Head and Neck Surgery
  • Oncology

Background:

  • Many cancers of unknown primary (CUP) are identified as HPV-associated oropharyngeal squamous cell carcinoma.
  • Accurate primary tumor localization is crucial for effective treatment and reducing adjuvant therapy.

Purpose of the Study:

  • To evaluate the efficacy of transoral robotic surgery (TORS) in identifying the primary tumor in patients with HPV-associated CUP.
  • To assess recurrence rates and the necessity of adjuvant therapy following TORS for CUP.

Main Methods:

  • Retrospective analysis of 48 patients with HPV-associated CUP who underwent TORS between 2019 and 2022.
  • Evaluation of primary tumor identification rate, local recurrence, and adjuvant therapy requirements.

Main Results:

  • TORS achieved an 87.5% primary tumor identification rate (42/48 patients).
  • 39.5% of patients avoided direct radiation to the primary site, and 20.8% received no radiation.
  • No local recurrences were observed, with three patients experiencing regional or distant recurrence.

Conclusions:

  • A primary surgical approach, such as TORS, should be considered for all patients diagnosed with HPV-associated CUP.
  • Precise tumor localization via TORS, guided by intraoperative pathology and a multidisciplinary approach, optimizes adjuvant therapy decisions.