Outcomes after salvage for HPV-positive recurrent oropharyngeal cancer treated with primary radiation

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12 Scopus citations

Abstract

Purpose: HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) carries a favorable prognosis for patients, yet nearly 30% of patients will experience disease relapse. We sought to detail patterns of failure, associated salvage therapy, and outcomes for patients with recurrent HPV-positive OPSCC. Methods and materials: This is a single institution retrospective study of patients with recurrent HPV-positive OPSCC irradiated from 2002 to 2014. The primary study outcome was overall survival (OS, calculated using the Kaplan-Meier method). Secondary aims included patterns of first failure with descriptive details of salvage therapy. Solitary recurrences were defined as initial presentation of recurrence in a single site (primary, neck or oligometastatic), and multi-site was defined as local and regional and/or multiple sites of distant recurrence. Survival outcomes were compared using the log-rank test. Results: The cohort consisted of 132 patients. The median follow-up was 59 months for surviving patients. Estimated 2-year and 5-year OS rates were 47% and 32%, respectively. Comparative 2-year and 5-year OS rates were 65% and 46% versus 19% and 9% for the solitary group and multi-site group, respectively (p < .001). Conclusions: Patients with recurrent HPV-positive OPSCC experience 5-year survival of approximately 32%. However, patients with a “solitary” recurrence including disease at the primary site, neck or oligometastatic site have more favorable long-term outcomes.

Original languageEnglish (US)
Article number105125
JournalOral Oncology
Volume113
DOIs
StatePublished - Feb 2021

Keywords

  • HPV-positive
  • Head and neck cancer
  • Oligometastatic disease
  • Oropharyngeal cancers
  • Patient outcomes
  • Patterns of failure
  • Salvage therapy
  • Squamous cell carcinoma

ASJC Scopus subject areas

  • Oral Surgery
  • Oncology
  • Cancer Research

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