Letters / Clinical Oncology 26 (2014) 174e177 Table 1 Factors associated with the likelihood of physician suspicion of hereditary breast-ovarian cancer syndrome (n ¼ 506) Taking a good family history

Yes (n ¼ 274) No (n ¼ 232) Constructing a genogram Yes (n ¼ 227) No (n ¼ 279) Taking a smoking and drinking history Yes (n ¼ 330) No (n ¼ 176) Patient risk categories Young-onset cancer (n ¼ 343) Breast cancer families (n ¼ 91) Breast and ovarian cancer families (n ¼ 50) Others (n ¼ 22)

Proportion of physiciansuspected hereditary breast-ovarian cancer syndrome, n (%) 127 (46.4) P [ 0.001 74 (31.9) 100 (44.1) 101 (36.2)

P ¼ 0.073

132 (40) 69 (39.2)

P ¼ 0.862

156 (45.5) 21 (23.1) 17 (34)

P [ 0.001

7 (31.8)

P-values that are statistically significant (70% of oropharyngeal cancers in Europe are HPV-positive [2], with excellent long-term survival rates [3]. The treatment method does

not influence survival in non-randomised comparisons [4], but has a significant effect on long-term function [5,6], which is highly relevant in young patients with HPVrelated disease. Two distinct treatment modalities for oropharyngeal cancer are established: primary chemoradiotherapy (CRT)

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Letters / Clinical Oncology 26 (2014) 174e177

Table 1 Summary of treatment modalities used (note: in those surgical patients who did not have transoral laser microsurgery, an open surgical approach was used) Centre

Primary treatment modality

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

Primary surgery (%)

Definitive radiotherapy or chemoradiotherapy (%)

50 30 2 20 45 30 50 10 10 2 90 40 100

% of surgical patients treated with transoral laser microsurgery

50 50 50 50 50 33 90 50 100 100 0 0 40 0 5 20 0

with surgical salvage; or primary surgery, usually with postoperative radiotherapy/CRT. In order to determine current UK practice, we distributed a questionnaire to clinical oncologists; 17 responded from different UK centres. The results highlight significant variation in UK practice. Definitive CRT is widely used, although the percentage of patients treated with surgery varies from 0 to 60% Table 1.

Transoral laser microsurgery is the main surgical procedure used, although open surgical approaches (requiring lip split mandibulotomy and free flap reconstruction) are still used in some centres. Most centres give postoperative CRT to patients with positive (

Management of oropharyngeal cancer - UK survey shows variations in practice.

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