The AJCC/UICC eighth edition for staging head and neck cancers: Is it wise to de-escalate treatment regimens in p16-positive oropharyngeal cancer patients?

High risk alpha human papillomaviruses (HPVs), and in particular HPV type 16, have been causally associated to a subset of oropharyngeal squamous cell carcinomas (OPSCCs) arising from the crypt epithelium of the palatine and lingual tonsils to which they confer a highly significant favorable prognosis. The Tumor Nodes Metastases (TNM) classification of malignant tumors, which is the internationally recognized standard for cancer staging, was developed by and continues to undergo the scrutiny of the concerted efforts of the Unio Internationalis Contra Cancrum (UICC) and the American Joint Committee on Cancer (AJCC). Its main objectives are to provide an indication of individual prognosis and aid treatment planning. These major changes proposed by the latest edition raise some concerns.