Ear, nose & throat · UKMLA & AKT
Oropharyngeal cancer
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
Key high-yield points
- Vast majority are squamous cell carcinomas (SCC) - two distinct pathways:
- HPV-related SCC - HPV-16 dominant; oncoproteins E6/E7 inactivate p53 and Rb respectively; loss of Rb causes compensatory p16 overexpression (used as surrogate marker); better prognosis, more radiosensitive
- Tobacco/alcohol-related SCC - carcinogen-driven mucosal field change; HPV-negative; worse prognosis; tobacco and alcohol act synergistically (multiplicative risk)
- In Western Europe, up to 93% of newly diagnosed oropharyngeal cancers are HPV-positive; HPV-positive disease affects younger, non-smoking patients
Tonsils and tonsillar fossae drain to the jugulodigastric (level II) anterior triangle nodes. The nasopharynx drains to the posterior triangle - a posterior triangle SCC node in an Asian patient points to nasopharyngeal primary.
Unlock the full Oropharyngeal cancer revision
Get the complete high-yield notes (4 more sections covering investigations, management and complications), practice questions, mock exams and Sal, the AI tutor. Start free.