Locoregional and distant recurrence for HPV-associated oropharyngeal cancer using AJCC 8 staging

• Published in: Oral oncology 2020-12, Vol.111, p.105030-105030, Article 105030
• Main Authors: Contrera, Kevin J., Smile, Timothy D., Mahomva, Chengetai, Wei, Wei, Adelstein, David J., Broughman, James R., Burkey, Brian B, Geiger, Jessica L., Joshi, Nikhil P., Ku, Jamie A., Lamarre, Eric D., Lorenz, Robert R., Prendes, Brandon L., Scharpf, Joseph, Schwartzman, Larisa M., Woody, Neil M., Xiong, David, Koyfman, Shlomo A.
• Format: Article
• Language: English
• Subjects: American Joint Committee on Cancer; Chemotherapy; Head and neck cancer; Human papillomavirus-associated; Metastasis; Oropharyngeal; Radiation; Recurrence; Squamous cell carcinoma
• ISSN: 1368-8375; 1879-0593
• DOI: 10.1016/j.oraloncology.2020.105030

•HPV-associated oropharyngeal cancer has unique patterns of recurrence.•Risk of locoregional recurrence is stratified by smoking, T/N category, and stage.•Risk of distant recurrence is only stratified by smoking and not by stage. The objective of this study is to evaluate locoregional and distant failure for human papillomavirus-associated (HPV+) oropharyngeal squamous cell carcinoma (OPSCC) using American Joint Committee on Cancer eighth edition (AJCC 8) staging. Retrospective cohort study of 457 patients with HPV + OPSCC, treated with platinum-based chemoradiation from 2002 to 2018, followed for a median of 4.3 years. Time to locoregional failure (TTLRF) and distant failure (TTDF) were estimated by Kaplan-Meier method. Log-rank, recursive partitioning analysis (RPA), and multivariable Cox proportional hazards were used to evaluate associated factors and stratify risk. Rates of five-year locoregional control (LRC) and distant control (DC) were 92% (95% CI, 90–95%) and 89% (95% CI, 85–92%), respectively. Smoking, T4, N3, and stage III were associated with significantly worse TTLRF. RPA identified three distinct locoregional failure groups: cT1-3 and