RT Journal Article
SR Electronic
T1 Surveillance Imaging in HPV-related Oropharyngeal Cancer
JF Anticancer Research
JO Anticancer Res
FD International Institute of Anticancer Research
SP 1525
OP 1529
VO 38
IS 3
A1 WILLIAM SU
A1 BRETT A. MILES
A1 MARSHALL POSNER
A1 PETER SOM
A1 LALE KOSTAKOGLU
A1 VISHAL GUPTA
A1 RICHARD L. BAKST
YR 2018
UL http://ar.iiarjournals.org/content/38/3/1525.abstract
AB Background/Aim: Current guidelines derived from a pre-human papilloma virus (HPV) era in oropharyngeal cancer do not recommend routine surveillance imaging. We aimed to analyze the method of recurrence detection in HPV+ disease to determine a role for follow-up imaging. Patients and Methods: All HPV+ and HPV− oropharyngeal cancer patients treated at our institution from 2005-2016 with biopsy-proven recurrence were identified and their method of recurrence detection was analyzed. Results: A total of 16 HPV+ oropharyngeal cancer patients were identified to have recurrence, 12 (75%) of which experienced distant recurrence and 13 (81.3%) were detected asymptomatically with imaging at a median time of 19.7 months after initial treatment and verifying no residual disease. Twelve (75%) detections were with PET-CT. While HPV− patients (17 patients) also have a high rate of asymptomatic detection (16 patients, 94.1%), their 3-year post-recurrence survival was significantly lower at 6.5% compared to 83.6% for the HPV+ group (p<0.01). Conclusion: In HPV+ patients, a large proportion of failures are asymptomatic distant metastases, which occur beyond 6 months following treatment completion, and are detected with whole body imaging alone. In light of long term post-recurrence survival observed, this preliminary data suggests that routine surveillance imaging should be further studied for HPV+ disease.