09-11, 09:00–10:00 (Europe/Istanbul), Head & Neck 3 (ICC - B3 Floor - 3B/38)
Oropharyngeal squamous cell carcinoma, particularly in the context of HPV-associated disease, continues to rise globally, affecting younger patients with excellent prognoses. This has shifted clinical priorities toward optimizing long-term function and minimizing treatment toxicity. Minimally invasive techniques like TORS offer promising alternatives to radiation-based therapies, yet comparative data have been limited—until recently.
Simultaneously, advances in molecular diagnostics such as ctHPV-DNA are providing new tools to monitor patients after treatment, enabling earlier and more accurate detection of recurrence. Denmark has led two national efforts addressing these frontiers: a randomized clinical trial comparing TORS and IMRT, and the first national rollout of ctHPV-DNA surveillance for OPSCC.
These initiatives represent a model of how rigorous research and system-wide implementation can converge to advance cancer care. This session will provide a comprehensive overview of the evidence and practical implications, offering attendees actionable insights into the future of OPSCC diagnostics, treatment, and follow-up.
This session highlights innovative approaches in the management of OPSCC, with a focus on improving precision, outcomes, and patient quality of life. Attendees will gain insights from two major national initiatives in Denmark: a randomized controlled trial (RCT) comparing TORS and IMRT in early-stage OPSCC, and the nationwide implementation of circulating tumor DNA testing for post-treatment surveillance of HPV-associated disease.
The RCT provides timely evidence on how TORS and IMRT compare in terms of functional outcomes and oncologic control, helping clinicians navigate the growing demand for treatment de-escalation. In parallel, the session will explore how ctHPV-DNA is being used as a non-invasive biomarker to detect minimal residual disease and early recurrence, offering a transformative surveillance strategy.
Together, these two initiatives represent a shift toward more personalized and less invasive care in OPSCC. The session will explore how combining surgical innovation with molecular diagnostics may shape future standards and support more targeted, effective, and patient-friendly treatment pathways.
Outcome objectives:
By the end of this session, participants will be able to:
1.Compare outcomes of TORS versus IMRT in early-stage OPSCC based on recent randomized trial data.
2.Explain the role of ctHPV-DNA in the surveillance of HPV-associated OPSCC.
3.Interpret real-world data from Denmark’s national ctHPV-DNA surveillance program
4.Examine the integration of surgical and molecular strategies for individualized patient management.
5.Recognize the clinical and logistical considerations of implementing novel diagnostics in routine care.
This international symposium will highlight innovative strategies in the management of HPV-associated oropharyngeal squamous cell carcinoma (OPSCC), focusing on two major Danish initiatives: a randomized trial comparing transoral robotic surgery (TORS) and intensity-modulated radiotherapy (IMRT), and the national implementation of circulating tumor HPV-DNA (ctHPV-DNA) for post-treatment surveillance. The session aims to foster global dialogue on integrating minimally invasive surgery and molecular diagnostics to support more precise, less toxic, and personalized care pathways in the evolving treatment landscape of OPSCC
Transoral robotic surgery
The use of robotics in head and neck cancer and benign disease is explored.
Current research areas include:
the use of robotics as a supplementary diagnostic modality in cancer of unknown primary in the head and neck
the use of robotics as a single modality treatment in early oropharyngeal cancer
cost-effectiveness of transoral robotic surgery compared to other modalities
Future ares of interest include the use of robotics in the treatment of obstructive sleep apnea and tumors in other pharyngeal sites, the larynx, the paraphaoryngeal space, and soft tissues of the neck.
Cancer of unknown primary
Cancer of unknown primary in the head and neck is an increasing challenge and improved diagnostic efficacy is needed. Research within this field focuses on:
evaluation of current diagnostic modalities
evaluation of new methods including transoral robotics
assessment of treatment outcomes based on the DAHANCA-database
exploration of emerging technologies including targeted imaging
Cost-effectiveness in head and neck cancer: treatment and rehabilitation
The costs of head and neck cancer treatment in Denmark is poorly described. A number of projects aim to explore the costs and the cost effectiveness of both radiation therapy and surgery in head and neck cancer
Central airway stenosis: work-up, treatment and outcome
Endoscopic treatment of central airway stenosis is explored. Main areas of interest are: diagnostic techniques, methodology during treatment, and outcomes.
Laryngeal intraepithelial neoplasia and glottic cancer: diagnostic work-up, treatment and outcome
Primary surgical treatment of laryngeal intraepithelial neoplasia and early stage laryngeal cancer (glottic cancer) was introduced in 2012 based on the principles of transoral laser-microsurgery. Along with this approach, new diagnostic techniques were introduced. Research in this field focuses on the efficacy of the diagnostic work-up as well as treatment outcome and morbidity.
Medical doctor, specialized head and neck surgeon, MD, PhD, DMSci
Dr. Chris Holsinger currently serves as Professor of Head and Neck Surgery and Director of the Head and Neck Oncology Program at Stanford University.
Dr Holsinger's research focuses on robotics, surgical innovation, AI, and clinical trials. In 2005, he described the surgical anatomy of the lateral oropharynx in English which helped to advance the burgeoning field of transoral robotic surgery. He helped refine several TORS techniques and served as the principal investigator of the FDA investigational device exemption trial in 2016-2017 for the single-port robotic surgical system.
He currently serves Chair of the Surgical Subcommittee, for the NRG Oncology’s Head and Neck Working Group. He served as surgical PI for RTOG920, the largest post-op clinical trial in H&N oncology, and also served as head of surgeon credentialing for ECOG3311. His current research focuses on AI in surgery and endoscopy, cognitive world models, autonomy, as well as multimodal profiling of HPV-mediated oropharynx cancer.
He graduated in 1990 cum laude from Vanderbilt College of Arts and Sciences with a major in molecular biology and in 1995 with his medical degree from Vanderbilt School of Medicine. He completed his internship and residency at Baylor College of Medicine and his Fellowship in head and neck surgical oncology at The University of Texas M. D. Anderson Cancer Center. In 2003, he was awarded Fulbright Scholarship to study surgery at the University of Paris with Professor Ollivier Laccourreye and with Professor Wolfgang Steiner at the Georg-August University in Göttingen. From 2003-2013, Dr. Holsinger worked at the Department of Head and Neck Surgery at the University of Texas M.D. Anderson Cancer Center. In 2013, Dr. Holsinger moved to Stanford University to serve as Chief of Head and Neck Surgery, where he also led H&N Multidisciplinary Cancer Care Clinical Program.