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Dr. Mehanna on the Updated Staging System for HPV+ Head and Neck Cancer

Hisham Mehanna, PhD, BMedSc, MBChB, FRCS
Published: Thursday, Oct 25, 2018



Hisham Mehanna, PhD, BMedSc, MBChB, FRCS, chair, Head and Neck Surgery director, Institute of Head and Neck Studies and Education at the School of Cancer Studies, University of Birmingham, discusses the new staging system for patients with HPV-positive head and neck cancer.

The staging system for the treatment of patients with head and neck cancer has been revised, as the previous one did not correctly reflect the prognosis of each stage, according to Mehanna. There are 2 parts to this new system—staging before a patient has recieved treatment, and then staging for those who have received surgery and need further treatment.

Before treatment, the nodal staging has become more simplified, Mehanna says. It has now been simplified to N0, N1, N2 or N3. Additionally, patients are categorized as having either unilateral or bilateral disease of more than 6 cm or less than 6 cm.

The staging groups have changed, as well. Patients who used to be deemed stage 4, have now because of their positive HPV status, been moved to stage 2. Mehanna says that due to the good prognosis that HPV has, the system has been changed.


Hisham Mehanna, PhD, BMedSc, MBChB, FRCS, chair, Head and Neck Surgery director, Institute of Head and Neck Studies and Education at the School of Cancer Studies, University of Birmingham, discusses the new staging system for patients with HPV-positive head and neck cancer.

The staging system for the treatment of patients with head and neck cancer has been revised, as the previous one did not correctly reflect the prognosis of each stage, according to Mehanna. There are 2 parts to this new system—staging before a patient has recieved treatment, and then staging for those who have received surgery and need further treatment.

Before treatment, the nodal staging has become more simplified, Mehanna says. It has now been simplified to N0, N1, N2 or N3. Additionally, patients are categorized as having either unilateral or bilateral disease of more than 6 cm or less than 6 cm.

The staging groups have changed, as well. Patients who used to be deemed stage 4, have now because of their positive HPV status, been moved to stage 2. Mehanna says that due to the good prognosis that HPV has, the system has been changed.

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