Negative Second PET-CT 1 Year After Treatment of Oropharyngeal Cancer Predicts Low Mortality and Recurrence

Objective

To determine the prediction value of a second PET-CT imaging study performed 1 year after treatment for patients with oropharyngeal carcinoma.

Methods

A Retrospective single-institution tertiary care centre study. Included are all patients diagnosed with oropharyngeal cancer between 2010 and 2020 at a tertiary medical centre. All 77 suitable patients completed at least two ET-CT scans during the post-treatment period, the first at 3 months and the second at 1 year. The follow-up extended to 5 years after treatment. The main outcome measures were overall survival (OS) and disease-free survival (DFS).

Results

In total, 55 (65%) patients had no evidence of disease (NED) on the 1-year PET-CT. The negative predictive value of 1-year PET-CT was 91% for 4-year DFS and 100% for 4-year OS. Regression analysis of NED on the 1-year PET-CT correlated with 5-year DFS (odds ratio [OR] 55, 95% confidence interval [CI] 5.2–500, p = 0.001) and low probability of 5-year recurrence rates (OR 11.23, 1.23–100, p = 0.03).

Conclusions

The findings of this study demonstrate that NED on PET-CT performed 1 year after the completion of treatment for oropharyngeal cancer is indicative of very low recurrence rates and almost non-existent mortality. We suggest performing a second PET-CT study at 1 year post-treatment on all patients with negative results on the first one performed at 3 months post-treatment. Negative findings on the second study may allow for a more lenient clinical follow-up protocol.