OROPHARYNGEAL TUMORS, DIAGNOSTIC AND TREATMENT

Tumori orofarinksa svrstavaju se u skupinu tumora glave i vrata koji se nalaze na šestom mjestu po učestalosti tumora u svijetu. Razlikujemo benigne i maligne tumore orofarinksa. U zadnjih nekoliko desetljeća bilježi se značajan porast broja oboljelih od karcinoma orofarinksa, dok broj ostalih tumora glave i vrata stagnira ili bilježi pad. Iako se većina karcinoma orofarinksa dijagnosticira kod muškaraca srednje i starije životne dobi, koji puše i konzumiraju alkohol, danas se bilježi porast incidencije kod mlađih od 45 godina. Pojava karcinoma kod mlađe populacije povezuje se s infekcijom humanim papiloma virusom (HPV). HPV pozitivni tumori orofarinksa pogodniji su za liječenje te imaju znatno veću stopu preživljenja u usporedbi s HPV negativnim tumorima. Svakog pacijenta sa simptomima koji upućuju na tumor orofarinksa treba uputiti otorinolaringologu na daljnju obradu koja uključuje fizikalni i endoskopski pregled, biopsiju i radiološke pretrage. Kada se dijagnosticira tumor orofarinksa liječenje se provodi ovisno o stadiju bolesti, a samo multidisciplinarni pristup omogućuje uspješan rezultat. Tim koji sudjeluje u liječenju sastoji se od otorinolaringologa, onkologa, radiologa, patologa, anesteziologa, logopeda, nutricionista, psihologa i stomatologa. U velikom broju slučajeva pacijenti se javljaju liječniku s uznapredovalim tumorom, a simptomi koji ih najčešće dovode su bolno grlo ili pojava kvržice na vratu. Liječenje uznapredovalih karcinoma vrlo često iziskuje opsežne kirurške zahvate koji rezultiraju većim defektima i smanjenom kvalitetom života. Stoga je rano prepoznavanje tumora preduvjet za uspješno liječenje i povoljnu prognozu.Oropharyngeal tumors are classified into the group of head and neck tumors, which are the sixth most common tumors worldwide. There are two types of oropharyngeal tumors: benign and malignant tumors. In the last few decades an increase in the incidence of oropharyngeal cancer has been noted, while the number of other head and neck tumors stagnates or declines. Although most oropharyngel cancers are diagnosed in middle and older- aged men who smoke and consume alcohol, there is an increase in the incidence of oropharyngeal cancer in people younger than 45. The occurence of cancer among younger population is associated with human papiloma virus infection (HPV). HPV- positive oropharyngeal tumors are more suitable for treatment and have significantly higher survival rate than HPV- negative tumors. Any patient with symptoms suggesting oropharyngeal cancer should be referred to an otolaryngologist for further evaluation including physical and endoscopic examination, biopsy and radiological examination. When oropharyngeal tumor is diagnosed the treatment options depend on the stage of the disease, and the best results are achieved through a multidisciplinary approach. The team involved in the treatment consists of otolaryngologist, oncologist, radiologist, pathologist, anesthesiologist, speech therapist, nutritionist, psychologist and dentist. In many cases, patients come to a doctor with advanced tumors, and the most common symptoms are sore throat and a lump in the neck. The treatment of advanced cancers often requires extensive surgery which results in major defects and reduced quality of life. Therefore, an early recognition of tumor is a prerequisite for successful treatment and favourable prognosis