Long-term outcomes in patients with recurrent human papillomavirus-positive oropharyngeal cancer after upfront transoral robotic surgery

William Su; Greeshma Rajeev-Kumar; Martin Kang; Marshall Posner; Jerry T. Liu; William Westra; Brett A. Miles; Vishal Gupta; Sonam Sharma; Krzysztof Misiukiewicz; Eric Genden; Richard L. Bakst

doi:10.1002/hed.26396

Long-term outcomes in patients with recurrent human papillomavirus-positive oropharyngeal cancer after upfront transoral robotic surgery

William Su, Greeshma Rajeev-Kumar, Martin Kang, Marshall Posner, Jerry T. Liu, William Westra, Brett A. Miles, Vishal Gupta, Sonam Sharma, Krzysztof Misiukiewicz, Eric Genden, Richard L. Bakst

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

Background: Clinical course following failure of human papillomavirus (HPV)-positive oropharyngeal cancers (HPV + OPC) is poorly understood. This study aims to characterize disease course following failure after transoral robotic surgery (TORS). Methods: We identified patients with HPV + OPC-treated upfront with TORS at our institution from 2007 to 2017. HPV status was confirmed with immunohistochemistry or HPV DNA polymerase chain reaction. Patient characteristics, treatment modalities, and post-recurrence outcomes were analyzed for the recurrent cohort. Results: Of the 317 HPV + OPC patients, 28 (8.8%) experienced recurrence, all of HPV 16/18 subtypes. Median post-recurrence survival was 19.8 months (range 2.3-195.8 months) in the 12 locoregional and 16 months (range 2.4-79.5 months) in the 14 distant failures. Sixteen are alive with a median of 39.8 months (range 5.5-209.4 months) after retreatment. Conclusion: This is one of the largest series evaluating survival following TORS failure in HPV + OPC. Despite failure, long-term survival and durable remission are possible with single-modal or multiple-modal salvage treatment.

Original language	English
Pages (from-to)	3490-3496
Number of pages	7
Journal	Head and Neck
Volume	42
Issue number	12
DOIs	https://doi.org/10.1002/hed.26396
State	Published - Dec 2020

Keywords

HPV
TORS
head and neck
oropharyngeal
recurrent

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10.1002/hed.26396

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@article{f794a2b34c214397b5f344c292ffc971,

title = "Long-term outcomes in patients with recurrent human papillomavirus-positive oropharyngeal cancer after upfront transoral robotic surgery",

abstract = "Background: Clinical course following failure of human papillomavirus (HPV)-positive oropharyngeal cancers (HPV + OPC) is poorly understood. This study aims to characterize disease course following failure after transoral robotic surgery (TORS). Methods: We identified patients with HPV + OPC-treated upfront with TORS at our institution from 2007 to 2017. HPV status was confirmed with immunohistochemistry or HPV DNA polymerase chain reaction. Patient characteristics, treatment modalities, and post-recurrence outcomes were analyzed for the recurrent cohort. Results: Of the 317 HPV + OPC patients, 28 (8.8%) experienced recurrence, all of HPV 16/18 subtypes. Median post-recurrence survival was 19.8 months (range 2.3-195.8 months) in the 12 locoregional and 16 months (range 2.4-79.5 months) in the 14 distant failures. Sixteen are alive with a median of 39.8 months (range 5.5-209.4 months) after retreatment. Conclusion: This is one of the largest series evaluating survival following TORS failure in HPV + OPC. Despite failure, long-term survival and durable remission are possible with single-modal or multiple-modal salvage treatment.",

keywords = "HPV, TORS, head and neck, oropharyngeal, recurrent",

author = "William Su and Greeshma Rajeev-Kumar and Martin Kang and Marshall Posner and Liu, {Jerry T.} and William Westra and Miles, {Brett A.} and Vishal Gupta and Sonam Sharma and Krzysztof Misiukiewicz and Eric Genden and Bakst, {Richard L.}",

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year = "2020",

month = dec,

doi = "10.1002/hed.26396",

language = "English",

volume = "42",

pages = "3490--3496",

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issn = "1043-3074",

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T1 - Long-term outcomes in patients with recurrent human papillomavirus-positive oropharyngeal cancer after upfront transoral robotic surgery

AU - Su, William

AU - Rajeev-Kumar, Greeshma

AU - Kang, Martin

AU - Posner, Marshall

AU - Liu, Jerry T.

AU - Westra, William

AU - Miles, Brett A.

AU - Gupta, Vishal

AU - Sharma, Sonam

AU - Misiukiewicz, Krzysztof

AU - Genden, Eric

AU - Bakst, Richard L.

PY - 2020/12

Y1 - 2020/12

N2 - Background: Clinical course following failure of human papillomavirus (HPV)-positive oropharyngeal cancers (HPV + OPC) is poorly understood. This study aims to characterize disease course following failure after transoral robotic surgery (TORS). Methods: We identified patients with HPV + OPC-treated upfront with TORS at our institution from 2007 to 2017. HPV status was confirmed with immunohistochemistry or HPV DNA polymerase chain reaction. Patient characteristics, treatment modalities, and post-recurrence outcomes were analyzed for the recurrent cohort. Results: Of the 317 HPV + OPC patients, 28 (8.8%) experienced recurrence, all of HPV 16/18 subtypes. Median post-recurrence survival was 19.8 months (range 2.3-195.8 months) in the 12 locoregional and 16 months (range 2.4-79.5 months) in the 14 distant failures. Sixteen are alive with a median of 39.8 months (range 5.5-209.4 months) after retreatment. Conclusion: This is one of the largest series evaluating survival following TORS failure in HPV + OPC. Despite failure, long-term survival and durable remission are possible with single-modal or multiple-modal salvage treatment.

AB - Background: Clinical course following failure of human papillomavirus (HPV)-positive oropharyngeal cancers (HPV + OPC) is poorly understood. This study aims to characterize disease course following failure after transoral robotic surgery (TORS). Methods: We identified patients with HPV + OPC-treated upfront with TORS at our institution from 2007 to 2017. HPV status was confirmed with immunohistochemistry or HPV DNA polymerase chain reaction. Patient characteristics, treatment modalities, and post-recurrence outcomes were analyzed for the recurrent cohort. Results: Of the 317 HPV + OPC patients, 28 (8.8%) experienced recurrence, all of HPV 16/18 subtypes. Median post-recurrence survival was 19.8 months (range 2.3-195.8 months) in the 12 locoregional and 16 months (range 2.4-79.5 months) in the 14 distant failures. Sixteen are alive with a median of 39.8 months (range 5.5-209.4 months) after retreatment. Conclusion: This is one of the largest series evaluating survival following TORS failure in HPV + OPC. Despite failure, long-term survival and durable remission are possible with single-modal or multiple-modal salvage treatment.

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KW - oropharyngeal

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Long-term outcomes in patients with recurrent human papillomavirus-positive oropharyngeal cancer after upfront transoral robotic surgery

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