Rate of locoregional recurrence among patients with oropharyngeal squamous cell carcinoma with known HPV status: a systematic review

Abstract

Background: We aimed to review systematically the literature on locoregional recurrence rates in patients with HPV-positive and-negative oropharyngeal squamous cell carcinoma (OPSCC). Methods: PubMed and Embase databases were systematically searched using key words such as human papillomavirus, oropharyngeal squamous cell carcinoma with local, regional, and locoregional recurrence. Results: Nine studies (2974 patients with known HPV-status, 59% HPV-positive) were included. Among the HPV-positive and-negative patients, 69% and 58% had lymph node metastasis at diagnosis. At a median time to recurrence ranging from 8.4 to 13.2 months among the included studies, we found that a weighted average of 9% and 26% for HPV-positive and-negative patients experienced locoregional recurrence. Overall, the median follow-up time ranged from 21 to 83 months among the included studies. Conclusion: Recurrence rates for HPV-positive and-negative OPSCC patients were 9% and 26%, respectively, equating to an almost three times higher rate of locoregional recurrence among HPVnegative patients compared to HPV-positive patients.

Nodal tumor volume as a prognostic factor for head and neck squamous cell carcinoma: a systematic review

“…In some studies patients were stratified into highrisk volumetric subgroups [20,21,23,25,44,45]. The great majority of these studies (5 out of 6) focused on carcinomas of the pharynx (two studies [20,45] on hypopharyngeal SCC and three studies [21,23,25] on oropharyngeal SCC).…”

“…Nodal volumetric analysis in patients with oropharyngeal, both HPV-positive and HPV-negative, and hypopharyngeal carcinomas appears to represent a challenging and promising field for research. Of particular note, in a quite recent systematic review [44], it was shown that the locoregional recurrence rates for HPV-negative (26%) patients are significantly higher (i.e., almost three times higher) as compared to HPV-positive (9%) OPSCC patients. This finding, in combination with the results of a multicentric study by Culie et al (2021) [45], wherein pri-mary surgical treatment in patients with p16-negative OP-SCC was found to be associated with improved overall survival (OS), disease-specific survival (DSS) and RFS, further supporting that patients with p16-negative OPSCC represent a group at high risk for recurrence, and metastatic nodal tumor volume could serve as an independent and decisive factor for risk stratification.…”

The DNA Damage Response Is Differentially Involved in HPV-Positive and HPV-Negative Radioresistant Head and Neck Squamous Cell Carcinoma

“…Up to 26% and 10% of patients with locally advanced HPV-negative and HPV-positive HNSCC, respectively, are affected with locoregional recurrences after treatment [4,5]. Radioresistance is one of the main reasons behind tumor relapse seen in these patients [6,7].…”

Adaptive Dose Escalated Radiotherapy in Oropharyngeal Cancers: A Treatment Planning Feasibility Study

“…Around 60% of HNSCCs present with locally advanced but non-metastatic disease and are associated with poor survival outcomes [2]. The pattern of treatment failure is loco-regional; many patients go on to die from this disease without developing distant metastases [3][4][5]. Radical (chemo)radiotherapy ((C)RT) involving 6-7 weeks of daily RT with concurrent platinum-based chemotherapy is widely accepted as standard of care in locally advanced HNSCC.…”