Evidence-based guideline diagnosis, treatment, prevention and aftercare of oropharyngeal and hypopharyngeal carcinoma

Sep 23, 2026

The guideline is developed as a joint guideline for oropharyngeal and hypopharyngeal carcinoma. It highlights that oropharyngeal carcinoma has shown the strongest incidence increase among head and neck cancers over the last 20 years and is now the sixth most common cancer in men in Germany. The document distinguishes HPV16-positive and HPV16-negative oropharyngeal cancers and notes that HPV16 association for hypopharyngeal cancer has not been described. It covers surgery, transoral and external approaches, radiotherapy with or without chemotherapy, drug-based tumor therapy including classic chemotherapy and immuno-oncology, prevention and early detection, rehabilitation, and management of recurrences and distant metastases that are not curable.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages121

Reading Time5 h 5 min

AccessFree to download

Guideline scope for oropharyngeal and hypopharyngeal carcinoma

Epidemiology and HPV16-based stratification

Diagnostic and therapeutic spectrum

Early detection, prevention, and rehabilitation

Management of recurrence and distant metastases

Evidence-based guideline diagnosis, treatment, prevention and aftercare of oropharyngeal and hypopharyngeal carcinoma S3-Leitlinie zur Diagnostik, Therapie, Prävention und Nachsorge des Oround Hypopharynxkarzinoms Abstract The guideline is being drawn up as a joint guideline for oropharyngeal and hypopharyngeal carcinoma. Oropharyngeal carcinoma in particular has experienced the greatest increase in incidence among all head and neck carcinomas in the last 20 years and is now the sixth most common cancer in men in Germany. Together with hypopharyngeal carcinoma, these tumors are currently the most common cancer entity in the head and neck region. Due to the association with human papillomavirus type 16 (HPV16), we now distinguish two groups of oropharyngeal carcinomas in Germany: HPV16-positive (approx. 35%) and HPV-negative (approx. 65%) . A HPV16 association with hypopharyngeal carcinoma has not been described. The therapy covers the entire spectrum of head and neck surgery, including diversified reconstructive procedures, transoral and external approaches, the options for primary and adjuvant radiotherapy (possibly in combination with chemotherapy) and the current recommendations for drug-based tumor therapy, which range from classic chemotherapy to immuno-oncology. In addition, measures for early detection and prevention are carried out, with particular consideration of the HPV16-associated genesis of oropharyngeal carcinoma, as well as adequate rehabilitation after the primary treatment of oropharyngeal and hypopharyngeal carcinomas. Finally, the treatment options for recurrences or distant metastases that cannot be cured in the further course of the disease are shown and classified. Keywords: oropahyrnx carcinoma, hypopharynx carcinoma, head and neck cancer, p16, HPV16 Zusammenfassung Die Leitlinie wurde als gemeinsame Leitlinie für das Oro-und Hypopharynxkarzinom erstellt. Insbesondere das Oropharynxkarzinom zeichnetsich durch die stärkste Inzidenzzunahme unter allen Kopf-Hals-Karzinomen in den letzten 20 Jahren aus und rangiert mittlerweile an sechster Stelle der häufigsten Krebserkrankungen bei Männern in Deutschland. Zusammen mit dem Hypopharynxkarzinom sind diese Tumore die aktuellam häufigsten vertretene Krebsentität im Kopf-Hals-Bereich. Durch die Assoziation mit dem humanen Papillomavirus Typ 16 (HPV16) unterscheiden wir heute zwei Gruppen der Oropharynxkarzinome in Deutschland: die HPV16 positiven (ca. 35%) und HPV-negativen (ca. 65%) . Eine HPV16-Assoziation des Hypopharynxkarzinoms wird nicht beschrieben. Die Therapie umfasst das gesamte Spektrum der KopfHals-Chirurgie mitsamt diversifizierten rekonstruktiven Verfahren, transoralen und äußeren Zugängen, den Möglichkeiten der primären und adjuvanten Strahlentherapie (ggf. in Kombination Chemotherapie) sowie die aktuellen Empfehlungen zur medikamentösen Tumortherapie, die von der klassischen Chemotherapie bis zur Immunonkologie reichen. Andreas Dietz1 Kathy Taylor2 Oliver Bayer2 Susanne Singer2 Markus Follmann3 Monika Nothacker4 Thomas Langer3 Peter Klussmann5 Stephan Lang6 Thomas Hoffmann7 Georg Maschmeyer8 Susanne Wiegand9 Michael Fuchs10 Wilko Weichert11 Jochen Heß12 Orlando Guntinas-Lichius13 Tim Waterboer14 Michael Lell15 Jens Büntzel16 Panagiotis Balermpas17 Kerstin Schmidt18 Maria Steingräber19 Gunther Klautke20 Herbert Hellmund21 Gunthard Kissinger22 Peter Brossart23 Imad Maatouk24 Bernd Lethaus25 Jan Raguse26 Klaus Zöphel27 Kristina Lippach28 Fritz Sterr28 Des Weiteren werden Maßnahmen zur Früherkennung und Prävention unter besonderer Berücksichtigung der HPV16-assoziierten Genesedes Oropharynxkarzinoms, sowie der adäquaten Rehabilitation nach der primären Behandlung von Oro-und Hypopharynxkarzinomen ausgeführt. Schließlich werden die Möglichkeiten einer Behandlung bei nicht mehr kurativ therapiebaren Rezidiven bzw. Fernmetastasen im weiteren Verlauf der Erkrankung aufgezeigt und eingeordnet. Schlüsselwörter: Oropahyrnx-Karzinom

FAQs

How does the guideline classify oropharyngeal carcinoma in Germany?

It distinguishes two groups: HPV16-positive (about 35%) and HPV16-negative (about 65%) oropharyngeal carcinomas.

What treatment modalities does the guideline include?

It covers the full surgical spectrum (including reconstructive procedures and transoral/external approaches), options for primary and adjuvant radiotherapy (possibly with chemotherapy), and current recommendations for drug-based tumor therapy ranging from classic chemotherapy to immuno-oncology.

Does the guideline describe an HPV16 association for hypopharyngeal carcinoma?

No. A HPV16 association with hypopharyngeal carcinoma has not been described in the guideline.

Sep 23, 2026

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