title: The benefit of early PET/CT surveillance in HPV-associated head and neck squamous cell carcinoma.
abstract: OBJECTIVE
  To evaluate the ability of posttreatment positron emission tomography and computed tomography (PET/CT) to predict ultimate disease status in patients with head and neck squamous cell carcinoma and known human papillomavirus (HPV) status.
  
  
  METHODS
  Retrospective.
  
  
  METHODS
  Single tertiary academic referral center.
  
  
  METHODS
  Clinical and radiographic data, including HPV status, were available for 62 patients with head and neck squamous cell carcinoma who underwent treatment from 2005 to 2010.
  
  
  METHODS
  The first posttreatment PET/CT scan, performed between 4 and 16 weeks (median, 9 weeks) after treatment, was categorized as negative, probably negative, or positive for residual disease. The PET/CT and clinical follow-up results, including disease status, were obtained every 3 months thereafter.
  
  
  RESULTS
  Among the 62 patients, 35 results (56%) were negative, 15 (24%) were probably negative, and 12 (19%) were positive. Eight of the 27 HPV-negative patients were PET/CT positive compared with 4 of the 35 HPV-positive patients (Cochran-Armitage trend test, P = .11). The median follow-up for disease-free patients was 21 months from the completion of the treatment. Disease-free survival was associated with PET/CT outcome (log-rank P < .001) and HPV status (log-rank P = .01). Using recurrence at 2 years as a reference standard, the early PET/CT scans had a specificity of 69% (95% confidence interval [CI], 46%-91%) and a negative predictive value of 79% (95% CI, 57%-99%). All PET/CT-negative HPV-positive patients (n = 6) were free of disease at 2 years, although this proportion was not statistically different from the PET/CT-negative HPV-positive patients in this small cohort.
  
  
  CONCLUSIONS
  A negative posttreatment PET/CT result may have the potential to identify patients who are at very low risk of recurrence. The HPV status may augment the predictive utility of an initial negative PET/CT result.
authors: Department of Otolaryngology, Eye and Ear Institute, University of Pittsburgh School of Medicine, 200 Lothrop Street, Pittsburgh, PA 15213, USA. ferrrl@upmc.edu
authors: Irene
authors: I
authors: Zhang
authors: Barton F
authors: BF
authors: Branstetter
authors: Daniel M
authors: DM
authors: Beswick
authors: Jessica H
authors: JH
authors: Maxwell
authors: William E
authors: WE
authors: Gooding
authors: Robert L
authors: RL
authors: Ferris
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000821:virology; D004279:DNA, Viral / Q000032:analysis; D003937:Diagnosis, Differential; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000821:virology; D052162:Human papillomavirus 16 / Q000235:genetics*; D006801:Humans; D017403:In Situ Hybridization; D015994:Incidence; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D030361:Papillomavirus Infections / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000821:virology; D010414:Pennsylvania / Q000453:epidemiology; D011159:Population Surveillance / Q000379:methods*; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D015996:Survival Rate / Q000639:trends; D014057:Tomography, X-Ray Computed
chemical_list: D004279:DNA, Viral; D019788:Fluorodeoxyglucose F18