For HPV-negative head and neck cancer of unknown primary after proper work up and biopsies, what mucosal surface(s) do you cover?

What factors influence your decision?

How do you manage these cases differently than HPV positive cases?

Answer from: Radiation Oncologist at Academic Institution

The treatment for CUP has evolved quite a bit, and frankly, I don't think there is a true standard. Even in our group, we often don't have consensus with regards to whether to even treat mucosa and if treating, which sites.Very weak data suggests that whether you just treat the involved neck or chas...

Comments

Radiation Oncologist at UTMB
Always feel reassured when I am practicing similar...

Radiation Oncologist at Baptist Health Fort Smith
How would your thinking change with N3 disease? I ...

Radiation Oncologist at University of Texas MD Anderson Cancer Center
I agree

Answer from: Radiation Oncologist at Academic Institution

Assuming the patient is a heavy smoker, EBV- and Caucasian, I would cover the nasopharynx bilaterally (EBV- NPC in an Asian patient is less likely), ipsilateral oropharynx, whole supraglottic larynx, and ipsilateral hypopharynx. While the oral tongue and buccal mucosa are theoretically at risk, I wo...

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Radiation Oncologist at UTMB
This is the classic response that cannot be debate...

Radiation Oncologist at Cancer Treatment Center at Hazleton
Need to also consider skin cancer as the primary s...

Answer from: Radiation Oncologist at Academic Institution

Oropharynx and nasopharynx

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For HPV-negative head and neck cancer of unknown primary after proper work up and biopsies, what mucosal surface(s) do you cover?

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