Management of Recurrent HPV-Related Oropharyngeal Cancer

There is a rise in the incidence and prevalence of HPV-associated oropharyngeal squamous cell carcinoma in the population worldwide. In general, evidence of HPV is associated with a better prognosis and higher disease-free survival as compared to the HPV-negative oropharyngeal cancer population. However, even among these patients, there is a subset of patients who fail initial therapy and demonstrate evidence of either persistent or recurrent disease. This review will discuss the current literature regarding patient management after the initial treatment including surveillance and the use of imaging. Additionally, it will discuss the available literature regarding the management of recurrent oropharyngeal squamous cell carcinoma, specifically highlighting the literature relevant to patients with HPV-positive disease. The review will highlight the currently available literature regarding disease-free survival, overall survival, and other outcomes with different salvage modalities such as surgery, re-irradiation with or without chemotherapy, and stereotactic whole-body radiotherapy.