Predictive accuracy of first post-treatment PET/CT in HPV-related oropharyngeal squamous cell carcinoma.
OBJECTIVE
To determine whether the result of first posttreatment positron emission tomography and computed tomography (PET/CT) is predictive of outcome in patients with oropharyngeal squamous cell carcinoma (OPSCC), and whether PET/CT accuracy is affected by human papillomavirus (HPV) status.


METHODS
Retrospective review.


METHODS
Demographic, clinical, and radiographic data were available for 61 patients with OPSCC, treated in 2004 to 2012 at a single tertiary academic referral center, with at least one baseline and one posttreatment PET/CT. Clinical follow-up was obtained every 3 months thereafter. The median follow-up time was 36 months (range 3-100 months).


RESULTS
Of 61 patients, 48 (79%) had negative first posttreatment PET/CT results; and overall, 18 of the 61 patients (30%) recurred. All accuracy measures for PET/CT were higher in HPV-positive patients, including a 93% negative predictive value (NPV). Patients with positive PET/CT results had poorer survival on Kaplan-Meier analyses. On multivariate analysis of factors predictive of recurrence, two parameters were significant: HPV status (P = 0.0046) and PET/CT result (P <0.0001).


CONCLUSIONS
A negative first posttreatment PET/CT result is associated with better prognosis and rare recurrence, especially in patients with HPV-positive status. Less frequent radiologic surveillance is warranted in patients with HPV-positive OPSCC and a negative first posttreatment PET/CT scan.
Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh.
Yekaterina
Y
Koshkareva
Barton F
BF
Branstetter
John P
JP
Gaughan
Robert L
RL
Ferris
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000628:therapy* / Q000821:virology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009959:Oropharyngeal Neoplasms / Q000175:diagnosis* / Q000628:therapy* / Q000821:virology; D030361:Papillomavirus Infections / Q000150:complications; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
PET/CT; head and neck squamous cell carcinoma (HNSCC); human papillomavirus; oropharynx; surveillance