Sensitivity of post-treatment surveillance in detecting recurrence and metastasis in surgically treated HPV-positive oropharyngeal squamous cell carcinoma patients

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology Pub Date : 2025-12-01 Epub Date: 2025-11-01 DOI:10.1016/j.oraloncology.2025.107767

Agnes Q Zhu , Claire E Cassianni , Travis Haller , Thomas J. O’Byrne , Pablo Ochoa , Tissiana Vallecillo , Andrew Pumford , Felicia Olawuni , Eric J Moore , Daniel L Price , Kendall K Tasche , Linda X Yin , Daniel J Ma , Scott C Lester , Mauricio Gamez , Michelle A Neben Wittich , Katharine A Price , Kathryn M Van Abel , David M Routman

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引用次数: 0

Abstract

Introduction

There is a lack of data regarding the appropriate surveillance of HPV(+)OPSCC. Our study aims to determine the sensitivity of patient symptoms, physical exam findings, and imaging in identifying recurrence and disease progression.

Methods

Mayo Clinic IRB (22–000684) approval was obtained, and the departmental REDCap database was queried to identify all HPV(+)OPSCC patients from 01/01/2006 to 12/31/2021 at our tertiary care center. Surgically treated patients with pathologic specimens positive for HPV (confirmed with in-situ hybridization (ISH) and/or p16 immuno-histochemistry) without evidence of distant metastatic disease at diagnosis were included. Sensitivity, specificity, PPV, and NPV of patient symptoms, physical exam findings, and imaging for disease progression were assessed both overall and at each time point.

Results

142/1142 patients experienced disease progression. 70% of patients with disease progression were detected within the first two years of surveillance. 79 patients with disease progression were detected via routine surveillance imaging, 34 via patient-reported symptoms, and 5 via physical exam.

Routine surveillance imaging was the most sensitive method of detection for locoregional recurrence (sensitivity 92.3%, PPV 6.5%, NPV 42.9%) and distant metastasis (sensitivity 100%, PPV 6.7%, NPV 100.0%). Patient symptoms in aggregate had a 73.1% sensitivity for detecting locoregional recurrence (PPV 8.7%, NPV 95.4%); however no individual symptom had a sensitivity over 30%. Physical exam findings were the least sensitive method of detection.

Conclusion

Our findings demonstrate that the majority of recurrences are detected within the first two years of surveillance. Routine surveillance imaging is the most sensitive modality for detecting disease progression as compared to patient symptoms or physical exam findings. Additional studies integrating newer technologies, such as ctHPVDNA. into surveillance are needed.

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术后监测检测hpv阳性口咽鳞状细胞癌复发和转移的敏感性

关于HPV(+)OPSCC的适当监测缺乏数据。我们的研究旨在确定患者症状、体检结果和影像学在确定复发和疾病进展方面的敏感性。方法获得smayo Clinic IRB（22-000684）批准，并查询部门REDCap数据库，确定2006年1月1日至2021年12月31日在我们三级保健中心的所有HPV(+)OPSCC患者。手术治疗的HPV病理标本阳性（原位杂交（ISH）和/或p16免疫组织化学证实），在诊断时没有远处转移性疾病的证据。对患者症状、体格检查结果和疾病进展影像的敏感性、特异性、PPV和NPV进行总体和每个时间点的评估。结果142/1142例患者出现疾病进展。70%的疾病进展患者在监测的头两年内被发现。79例患者通过常规监测成像发现疾病进展，34例通过患者报告的症状，5例通过体检。常规监测影像学是检测局部复发（灵敏度92.3%,PPV 6.5%, NPV 42.9%）和远处转移（灵敏度100%，PPV 6.7%, NPV 100.0%）最敏感的方法。患者总体症状检测局部复发的敏感性为73.1% (PPV为8.7%，NPV为95.4%)；然而，没有个别症状的敏感性超过30%。体检结果是最不敏感的检测方法。结论我们的研究结果表明，大多数复发是在监测的前两年发现的。与患者症状或体检结果相比，常规监测成像是检测疾病进展最敏感的方式。进一步的研究整合了较新的技术，如ctHPVDNA。监控是必要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oral oncology 医学-牙科与口腔外科

CiteScore

8.70

自引率

10.40%

发文量

505

审稿时长

20 days

期刊介绍： Oral Oncology is an international interdisciplinary journal which publishes high quality original research, clinical trials and review articles, editorials, and commentaries relating to the etiopathogenesis, epidemiology, prevention, clinical features, diagnosis, treatment and management of patients with neoplasms in the head and neck. Oral Oncology is of interest to head and neck surgeons, radiation and medical oncologists, maxillo-facial surgeons, oto-rhino-laryngologists, plastic surgeons, pathologists, scientists, oral medical specialists, special care dentists, dental care professionals, general dental practitioners, public health physicians, palliative care physicians, nurses, radiologists, radiographers, dieticians, occupational therapists, speech and language therapists, nutritionists, clinical and health psychologists and counselors, professionals in end of life care, as well as others interested in these fields.