Surgically Based Deintensification for Oropharyngeal Cancer: Current Concepts and Future Directions.

The paradigm for management of human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (HPV + OPC) has evolved significantly in recent years. Following the interim futility analysis of NRG HN005, which reaffirmed standard-dose cisplatin-based chemoradiation as the standard of care in the nonsurgical setting, this review examines whether surgical approaches now represent the most viable path to treatment deintensification for appropriate patients with HPV + OPC. In this narrative review, we summarize data from key surgical deintensification clinical trials, discuss surgeon credentialing considerations, and review emerging technologies that may further refine patient selection and treatment response assessment.