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Disease‐free survival after salvage therapy for recurrent oropharyngeal squamous cell carcinoma
Author(s) -
Joseph Andrew W.,
Guo Theresa,
Hur Kevin,
Xie Yanjun,
Yin Linda,
Califano Joseph A.,
Ha Patrick K.,
Quon Harry,
Richmon Jeremy D.,
Eisele David W.,
Agrawal Nishant,
Fakhry Carole
Publication year - 2016
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24268
Subject(s) - medicine , salvage therapy , hazard ratio , confidence interval , oncology , context (archaeology) , surgery , retrospective cohort study , chemotherapy , paleontology , biology
Background Factors associated with disease‐free survival (DFS) after salvage therapy for recurrent oropharyngeal squamous cell carcinoma (SCC) in the context of human papillomavirus (HPV) are poorly understood. Methods A retrospective cohort analysis was conducted of patients with recurrent oropharyngeal SCC with known HPV tumor status who received salvage therapy. Results Eighty‐six patients were eligible for analysis. Sixty‐four patients (74%) were HPV‐positive. In multivariable analysis, HPV‐positive tumor status (hazard ratio [HR] = 0.30; 95% confidence interval [CI] = 0.13–0.71; p = .007), clinical response to any salvage therapy (HR = 0.29; 95% CI = 0.11–0.77; p = .01), and surgical salvage (HR = 0.38; 95% CI = 0.16–0.88; p = .02) were associated with improved overall survival (OS). Positive surgical margin was associated with worse DFS after salvage (HR = 8.43; 95% CI = 1.99–35.70; p = .004). Conclusion For recurrent oropharyngeal SCC, HPV‐positive tumor status, surgical salvage, and clinical response to salvage therapy are independently associated with improved OS, but not DFS after salvage. Surgical margin is the only independent predictor of DFS. © 2015 Wiley Periodicals, Inc. Head Neck 38 : E1501–E1509, 2016