Outcomes of relapsed human papillomavirus‐related oropharyngeal squamous cell carcinoma treated with curative intent

Abstract

Background With most centers reporting excellent disease control following transoral surgery for human papillomavirus (HPV)‐related oropharyngeal cancer, data are still lacking regarding management and outcomes in patients who relapse. We describe the treatment outcomes after curative intent therapy for locoregional and distant relapse following transoral surgery for HPV‐related oropharyngeal squamous cell carcinoma (OPSCC). Methods A single institution retrospective study in which patients were identified with curatively treated loco‐regional or single site distant relapse of HPV‐related OPSCC treated initially with transoral surgery (TOS) between 1996 and 2014. Results Among 279 patients, 38 (13.6%) relapsed. 21 (7.5%) had local‐regional relapse and 18 were treated with curative intent. Three‐year overall survival for loco‐regional recurrence with curatively intended treatment was 75.3% (95% confidence intervals 54.3‐96.0) with a median follow‐up 33 (range: 5‐65) months. Among 4 patients with isolated distant metastasis who were treated with curative intent, all subsequently developed second relapse of disease. Conclusion Salvage curative treatment of isolated local‐regional relapse after TOS is associated with favorable prognosis and should be offered in appropriate candidates.

Oropharyngeal squamous cell carcinoma: Prognostic factors for development of distant metastases and oncological outcomes

“…Some Authors reported that the presence of an LRr may be a predictor of developing DM, despite excellent loco-regional control of the recurrence. 33 This study has some limitations. Firstly, the retrospective design makes the results prone to recall bias or misclassification bias.…”

Transoral Robotic Surgery for Oropharyngeal Squamous Cell Carcinoma of the Tonsil versus Base of Tongue: A Systematic Review and Meta-Analysis

“…The recurrence of OPSCC after TORS was analyzed by subsite in 13 studies [ 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ]. There was no statistically significant difference in the odds of total recurrence between tonsillar and BOT OPSCC (1.1 [95%CI 0.8–1.5], p = 0.480) ( Figure 4 ).…”

Prediction of post-radiotherapy locoregional progression in HPV-associated oropharyngeal squamous cell carcinoma using machine-learning analysis of baseline PET/CT radiomics

“…LRP represents treatment failure of definite therapy in curative intent, with few remaining satisfactory options: Salvage surgery and irradiation are commonly associated with increased morbidity and impaired functionality; and while new immune checkpoint inhibitors alone or in addition to conventional systemic treatment improved outcome in patients not amenable to localized therapy, long-term control of relapsed HNSCC often remains fairly poor [39] , [40] , [41] . Locoregional relapse is also strongly tied to poor overall survival in HPV-associated OPSCC [ 8 , 10 ], substantiating the importance of this endpoint for therapeutic decision making in OPSCC.…”